Journal
BLOOD
Volume 120, Issue 20, Pages 4150-4159Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2012-04-421412
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Funding
- Associazione Italiana per la Ricerca sul Cancro, Milan, Italy [IG 10811]
- Programma di ricerca Regione-Universita Emilia Romagna
- Ministero dell'Istruzione, Universita e della Ricerca
- Societa Italiana Ematologia Sperimentale
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Posttransplantation human herpesvirus-8 (HHV8)/Kaposi sarcoma herpesvirus (KSHV) primary infection and/or reactivations are associated with uncommon and sometimes fatal, neoplastic, and nonneoplastic diseases. HHV8-related clinical manifestations notably range from Kaposi sarcoma (KS) to either primary effusion lymphoma or multicentric Castleman disease B-cell malignancies, and from polyclonal HHV8-positive plasmacytic lymphoproliferative disorders to bone marrow failure and peripheral cytopenias, associated or not with hemophagocytic syndromes, and to acute hepatitis syndromes. We reviewed the patient series reported in the literature and summarized clinical management aspects, in terms of diagnosis, follow-up, and treatment. We described typical clinical presentations and histopathologic diagnostic features of these diseases, and we discussed the role of HHV8-specific serologic, molecular, and immunologic assays, particularly focusing on recent data from HHV8-specific T-cell monitoring in posttransplantation KS patients. We finally discussed actual therapeutic options, namely, the reduction or discontinuation of immunosuppressive therapy or the switch from calcineurin inhibitors to mTOR inhibitors, as alternatives to antineoplastic chemotherapy, along with the use of antiherpesvirus agents as prophylactic or therapeutic measures, and treatment with rituximab in posttransplantation multicentric Castleman disease patients and non-neoplastic HHV8-associated syndromes. (Blood. 2012; 120(20): 4150-4159)
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