Abstract
Epstein-Barr virus (EBV)-associated B-cell lymphoproliferation is a life-threatening complication after hematopoietic stem cell or solid organ transplantation resulting from outgrowth of EBV-infected B cells that would normally be controlled by EBV-cytotoxic T cells. During the past decade, early detection strategies, such as serial measurement of EBV-DNA load in peripheral blood samples, have helped to identify high-risk patients and to diagnose early lymphoproliferation. Treatment options include manipulation of the balance between outgrowing EBV-infected B cells and the EBV cytotoxic T lymphocyte response and targeting the B cells with monoclonal antibodies or chemotherapy. Major challenges remain for defining indications for preemptive therapies and integrating novel and conventional therapies.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Antibodies, Monoclonal / therapeutic use
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Antiviral Agents / therapeutic use
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B-Lymphocytes / immunology
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B-Lymphocytes / virology
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Epstein-Barr Virus Infections / diagnosis
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Epstein-Barr Virus Infections / etiology
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Epstein-Barr Virus Infections / therapy*
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Hematopoietic Stem Cell Transplantation / adverse effects
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Herpesvirus 4, Human / immunology
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Herpesvirus 4, Human / pathogenicity
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Humans
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Lymphoproliferative Disorders / diagnosis
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Lymphoproliferative Disorders / etiology
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Lymphoproliferative Disorders / therapy*
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Rituximab
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T-Lymphocytes, Cytotoxic / immunology
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T-Lymphocytes, Cytotoxic / transplantation
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Tissue Donors
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Transplants / adverse effects
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Antiviral Agents
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Rituximab