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移植后血液系统恶性肿瘤的综合综述。

Comprehensive review of post-organ transplant hematologic cancers.

机构信息

Division of Pediatric Nephrology, Washington University School of Medicine, Saint Louis, MO, USA.

出版信息

Am J Transplant. 2018 Mar;18(3):537-549. doi: 10.1111/ajt.14603. Epub 2018 Jan 10.

Abstract

A higher risk for a variety of cancers is among the major complications of posttransplantation immunosuppression. In this part of a continuing series on cancers posttransplantation, this review focuses on the hematologic cancers after solid organ transplantation. Posttransplantation lymphoproliferative disorders (PTLDs), which comprise the great majority of hematologic cancers, represent a spectrum of conditions that include, but are not limited to, the Hodgkin and non-Hodgkin lymphomas. The oncogenic Epstein-Barr virus is a key pathogenic driver in many PTLD cases, through known and unknown mechanisms. The other hematologic cancers include leukemias and plasma cell neoplasms (multiple myeloma and plasmacytoma). Clinical features vary across malignancies and location. Preventive screening strategies have been attempted mainly for PTLDs. Treatments include the chemotherapy regimens for the specific cancers, but also include reduction of immunosuppression, rituximab, and other therapies.

摘要

移植后免疫抑制是各种癌症的主要并发症之一。在这一系列关于移植后癌症的持续系列中,本篇综述重点关注实体器官移植后的血液系统癌症。移植后淋巴组织增生性疾病(PTLD)构成了血液系统癌症的绝大多数,代表了一系列疾病,包括但不限于霍奇金和非霍奇金淋巴瘤。致癌的 EBV 通过已知和未知的机制成为许多 PTLD 病例的关键致病驱动因素。其他血液系统癌症包括白血病和浆细胞瘤(多发性骨髓瘤和浆细胞瘤)。各种恶性肿瘤和位置的临床表现存在差异。主要针对 PTLD 尝试了预防筛查策略。治疗包括特定癌症的化疗方案,但也包括减少免疫抑制、利妥昔单抗和其他疗法。

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