Rituximab for posttransplant lymphoproliferative disorder - therapeutic, preemptive, or prophylactic?
- Author(s)
- Storek, J; Lindsay, J;
- Details
- Publication Year 2024-01,Volume 59,Issue #1,Page 6-11
- Journal Title
- Bone Marrow Transplantation
- Publication Type
- Review
- Abstract
- To minimize mortality due to posttransplant lymphoproliferative disorder (PTLD), the following strategies have been used: (1) Therapy without EBV Monitoring, i.e., administration of rituximab after PTLD diagnosis, usually by biopsy, in the absence of routine Epstein-Barr virus (EBV) DNAemia monitoring, (2) Prompt Therapy, i.e., monitoring EBV DNAemia, searching for PTLD by imaging when the DNAemia has exceeded a pre-specified threshold, and administration of rituximab if the imaging is consistent with PTLD, (3) Preemptive Therapy, i.e., monitoring EBV DNAemia and administration of rituximab when the DNAemia has exceeded a pre-specified threshold, and (4) Prophylaxis, i.e., administration of rituximab to all transplant recipients. The superiority of one of these strategies over the other strategies has not been established. Here we review the pros and cons of each strategy. Preemptive therapy or prophylaxis may currently be preferred for patients who are at a high risk of dying due to PTLD. However, Therapy without EBV Monitoring may be used for both high- and low-risk patients in the future, if effective and relatively non-toxic therapies for rituximab-refractory PTLD (e.g., EBV-specific T cells) have become easily available.
- Publisher
- Springer Nature
- Keywords
- Humans; Rituximab/therapeutic use; *Epstein-Barr Virus Infections/prevention & control; Herpesvirus 4, Human; *Lymphoproliferative Disorders/drug therapy/etiology/prevention & control; *Hematopoietic Stem Cell Transplantation/adverse effects
- Department(s)
- Infectious Diseases
- Publisher's Version
- https://doi.org/10.1038/s41409-023-02155-5
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-02-20 07:04:50
Last Modified: 2024-02-20 07:05:27