期刊
AMERICAN JOURNAL OF TRANSPLANTATION
卷 5, 期 3, 页码 566-572出版社
WILEY
DOI: 10.1111/j.1600-6143.2004.00693.x
关键词
EBV; liver transplant; PTLD; rituximab
资金
- NCI NIH HHS [P01 CA94237] Funding Source: Medline
- NCRR NIH HHS [RR00188] Funding Source: Medline
- NIDDK NIH HHS [DK062329] Funding Source: Medline
The evaluation of long-term cellular immunity to EBV in pediatric orthotopic liver transplant (OLT) recipients after treatment with the humanized anti-CD20 monoclonal antibody (Rituximab) has not yet been explored. At our institution, one child with EBV-related mononucleosis-like syndrome and five children with polymorphic-EBV-PTLD occurring 6-88 months after OLT were treated with Rituximab. Treatment was well tolerated. All children achieved complete remission. After Rituximab, B-lymphocytes were undetectable in the peripheral blood and EBV-load, monitored with real-time PCR, decreased to undetectable levels in all children from > 4000 copies/mug DNA at diagnosis. Four to eight months after Rituximab, EBV-load increased (> 4000 copies/mug DNA) in four children, and PTLD recurred in three. Their frequency of EBV-specific T-cell precursors, measured by Elispot analysis, remained lower than in healthy controls. Rituximab effectively induced regression of PTLD in OLT recipients. However, EBV-specific T-cell immunocompetence, which may be crucial for the long-term control of EBV-mediated proliferation, did not improve.
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