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移植后淋巴组织增生性疾病的最新进展。

Update on posttransplant lymphoproliferative disease.

机构信息

Nephrology Department.

Hematology Department, Clinica Universidad de Navarra and Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.

出版信息

Curr Opin Nephrol Hypertens. 2018 Nov;27(6):440-444. doi: 10.1097/MNH.0000000000000457.

Abstract

PURPOSE OF REVIEW

Posttransplant lymphoproliferative disorder (PTLD), frequently associated with Epstein-Barr virus (EBV), is one of the most serious complications leading to worse patient and graft outcomes. Hence, we summarize in this review relevant studies published about PTLD in the last 18 months.

RECENT FINDINGS

Recent studies have improved the knowledge about epidemiology, prophylaxis, diagnosis and PTLD treatment. Special interest has developed in improving the last PTLD classification of the World Health Organization, increasing the accuracy of diagnostic tests for EBV viral load quantification and discriminating the genetic differences between PTLD types. There seems to be no real advantage in the use of antiviral drugs for prophylaxis, but better results in therapeutic approaches are being obtained mainly with the use of rituximab with or without chemotherapy, but also with the possibility of using adoptive T-cell therapy or new drugs.

SUMMARY

PTLD continues being a complication that requires continued effort of the scientific community to reduce its incidence and to develop better diagnostic tests and new strategies that improve results in prophylaxis and treatment.

摘要

目的综述

移植后淋巴组织增生性疾病(PTLD)常与 EBV 相关,是导致患者和移植物预后更差的最严重并发症之一。因此,我们对过去 18 个月中有关 PTLD 的相关研究进行了总结。

最新发现

最近的研究提高了对流行病学、预防、诊断和 PTLD 治疗的认识。人们对改善世界卫生组织(WHO)最新的 PTLD 分类、提高 EBV 病毒载量定量诊断检测的准确性以及区分 PTLD 类型的遗传差异特别感兴趣。抗病毒药物预防的使用似乎没有真正的优势,但主要使用利妥昔单抗联合或不联合化疗,以及采用过继性 T 细胞治疗或新药,在治疗方法中取得了更好的效果。

总结

PTLD 仍然是一种需要科学界持续努力的并发症,以降低其发病率,并开发更好的诊断检测和新的策略,以改善预防和治疗的效果。

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