Epstein-Barr virus-negative post-transplant lymphoproliferative disorders: A distinct entity?
Post-transplant lymphoproliferative disorders (PTLDs) are usually but not invariably associated with Epstein-Barr virus (EBV). The reported incidence, however, of EBV-negative PTLDs varies widely, and it is uncertain whether they should be considered analogous to EBV-positive PTLDs and whether they...
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| Veröffentlicht in: | The American journal of surgical pathology 2000-03, Vol.24 (3), p.375-385 |
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| container_title | The American journal of surgical pathology |
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| creator | NELSON, B. P NALESNIK, M. A BAHLER, D. W LOCKER, J FUNG, J. J SWERDLOW, S. H |
| description | Post-transplant lymphoproliferative disorders (PTLDs) are usually but not invariably associated with Epstein-Barr virus (EBV). The reported incidence, however, of EBV-negative PTLDs varies widely, and it is uncertain whether they should be considered analogous to EBV-positive PTLDs and whether they have any distinctive features. Therefore, the EBV status of 133 PTLDs from 80 patients was determined using EBV-encoded small ribonucleic acid (EBER) in situ hybridization stains with or without Southern blot EBV terminal repeat analysis. The morphologic, immunophenotypic, genotypic, and clinical features of the EBV-negative PTLDs were reviewed, and selected features were compared with EBV-positive cases. Twenty-one percent of patients had at least one EBV-negative PTLD (14% of biopsies). The initial EBV-negative PTLDs occurred a median of 50 months post-transplantation compared with 10 months for EBV-positive cases. Although only 2% of PTLDs from before 1991 were EBV negative, 23% of subsequent PTLDs were EBV negative (p |
| doi_str_mv | 10.1097/00000478-200003000-00006 |
| format | Article |
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P ; NALESNIK, M. A ; BAHLER, D. W ; LOCKER, J ; FUNG, J. J ; SWERDLOW, S. H</creator><creatorcontrib>NELSON, B. P ; NALESNIK, M. A ; BAHLER, D. W ; LOCKER, J ; FUNG, J. J ; SWERDLOW, S. H</creatorcontrib><description>Post-transplant lymphoproliferative disorders (PTLDs) are usually but not invariably associated with Epstein-Barr virus (EBV). The reported incidence, however, of EBV-negative PTLDs varies widely, and it is uncertain whether they should be considered analogous to EBV-positive PTLDs and whether they have any distinctive features. Therefore, the EBV status of 133 PTLDs from 80 patients was determined using EBV-encoded small ribonucleic acid (EBER) in situ hybridization stains with or without Southern blot EBV terminal repeat analysis. The morphologic, immunophenotypic, genotypic, and clinical features of the EBV-negative PTLDs were reviewed, and selected features were compared with EBV-positive cases. Twenty-one percent of patients had at least one EBV-negative PTLD (14% of biopsies). The initial EBV-negative PTLDs occurred a median of 50 months post-transplantation compared with 10 months for EBV-positive cases. Although only 2% of PTLDs from before 1991 were EBV negative, 23% of subsequent PTLDs were EBV negative (p <0.001). Of the EBV-negative PTLDs, 67% were of monomorphic type (M-PTLD) compared with 42% of EBV-positive cases (p <0.05). The other EBV-negative PTLDs were of infectious mononucleosis-like, plasma cell-rich (n = 2), small B-cell lymphoid neoplasm, large granular lymphocyte disorder (n = 4) and polymorphic (P) types. B-cell clonality was established in 14 specimens and T-cell clonality was established in three (two patients). None of the remaining specimens were studied with Southern blot analysis and some had no ancillary studies. Rearrangement of c-MYC was identified in two M-PTLDs with small noncleaved-like features, and rearrangement of BCL-2 was found in one large noncleaved-like M-PTLD. Ten patients were alive at 3 to 63 months (only three patients received chemotherapy). Seven patients, all with M-PTLDs, are dead at 0.3 to 6 months. Therefore, EBV-negative PTLDs have distinct features, but some do respond to decreased immunosuppression, similar to EBV-positive cases, suggesting that EBV positivity should not be an absolute criterion for the diagnosis of a PTLD.</description><identifier>ISSN: 0147-5185</identifier><identifier>EISSN: 1532-0979</identifier><identifier>DOI: 10.1097/00000478-200003000-00006</identifier><identifier>PMID: 10716151</identifier><identifier>CODEN: AJSPDX</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Female ; Genotype ; Hematologic and hematopoietic diseases ; Herpesvirus 4, Human - genetics ; Herpesvirus 4, Human - isolation & purification ; Humans ; Immunophenotyping ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Lymphoproliferative Disorders - immunology ; Lymphoproliferative Disorders - pathology ; Lymphoproliferative Disorders - virology ; Male ; Medical sciences ; Middle Aged ; Miscellaneous ; Organ Transplantation - adverse effects ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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W</creatorcontrib><creatorcontrib>LOCKER, J</creatorcontrib><creatorcontrib>FUNG, J. J</creatorcontrib><creatorcontrib>SWERDLOW, S. H</creatorcontrib><title>Epstein-Barr virus-negative post-transplant lymphoproliferative disorders: A distinct entity?</title><title>The American journal of surgical pathology</title><addtitle>Am J Surg Pathol</addtitle><description>Post-transplant lymphoproliferative disorders (PTLDs) are usually but not invariably associated with Epstein-Barr virus (EBV). The reported incidence, however, of EBV-negative PTLDs varies widely, and it is uncertain whether they should be considered analogous to EBV-positive PTLDs and whether they have any distinctive features. Therefore, the EBV status of 133 PTLDs from 80 patients was determined using EBV-encoded small ribonucleic acid (EBER) in situ hybridization stains with or without Southern blot EBV terminal repeat analysis. The morphologic, immunophenotypic, genotypic, and clinical features of the EBV-negative PTLDs were reviewed, and selected features were compared with EBV-positive cases. Twenty-one percent of patients had at least one EBV-negative PTLD (14% of biopsies). The initial EBV-negative PTLDs occurred a median of 50 months post-transplantation compared with 10 months for EBV-positive cases. Although only 2% of PTLDs from before 1991 were EBV negative, 23% of subsequent PTLDs were EBV negative (p <0.001). Of the EBV-negative PTLDs, 67% were of monomorphic type (M-PTLD) compared with 42% of EBV-positive cases (p <0.05). The other EBV-negative PTLDs were of infectious mononucleosis-like, plasma cell-rich (n = 2), small B-cell lymphoid neoplasm, large granular lymphocyte disorder (n = 4) and polymorphic (P) types. B-cell clonality was established in 14 specimens and T-cell clonality was established in three (two patients). None of the remaining specimens were studied with Southern blot analysis and some had no ancillary studies. Rearrangement of c-MYC was identified in two M-PTLDs with small noncleaved-like features, and rearrangement of BCL-2 was found in one large noncleaved-like M-PTLD. Ten patients were alive at 3 to 63 months (only three patients received chemotherapy). Seven patients, all with M-PTLDs, are dead at 0.3 to 6 months. Therefore, EBV-negative PTLDs have distinct features, but some do respond to decreased immunosuppression, similar to EBV-positive cases, suggesting that EBV positivity should not be an absolute criterion for the diagnosis of a PTLD.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Genotype</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Herpesvirus 4, Human - genetics</subject><subject>Herpesvirus 4, Human - isolation & purification</subject><subject>Humans</subject><subject>Immunophenotyping</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Lymphoproliferative Disorders - immunology</subject><subject>Lymphoproliferative Disorders - pathology</subject><subject>Lymphoproliferative Disorders - virology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Organ Transplantation - adverse effects</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><issn>0147-5185</issn><issn>1532-0979</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkEtLxDAQgIMo7rr6F6QH8RbNo20SL7IuvmDBy16lpOlUI32ZpAv7723t-ggMmQzfTIYPoYiSK0qUuCbjiYXEbEz4EHhM0gM0pwlneGDUIZoTGgucUJnM0In3H4RQJik7RjNKBE1pQufo9b7zAWyD77Rz0da63uMG3nSwW4i61gccnG58V-kmRNWu7t7bzrWVLcFNTGF96wpw_iZajo9gGxMiaIINu9tTdFTqysPZ_l6gzcP9ZvWE1y-Pz6vlGhsmk4BToNyUYFRccFWIIic5T2NGoNRCagVg0oSXLJZcCiZFoaQpc8kVaC54TPgCXU5jh9U-e_Ahq603UA1LQ9v7TBCVJjSRAygn0LjWewdl1jlba7fLKMlGs9mP2ezX7HcpHVrP93_0eQ3Fv8ZJ5QBc7AHtja7KQZux_o9jinJF-BfAqIIj</recordid><startdate>20000301</startdate><enddate>20000301</enddate><creator>NELSON, B. P</creator><creator>NALESNIK, M. A</creator><creator>BAHLER, D. W</creator><creator>LOCKER, J</creator><creator>FUNG, J. J</creator><creator>SWERDLOW, S. H</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000301</creationdate><title>Epstein-Barr virus-negative post-transplant lymphoproliferative disorders: A distinct entity?</title><author>NELSON, B. P ; NALESNIK, M. A ; BAHLER, D. W ; LOCKER, J ; FUNG, J. J ; SWERDLOW, S. H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c285t-6e13cfec94d39d7db0b36420efa78a9eec653f248387287d98cfb839ea373403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Genotype</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Herpesvirus 4, Human - genetics</topic><topic>Herpesvirus 4, Human - isolation & purification</topic><topic>Humans</topic><topic>Immunophenotyping</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Lymphoproliferative Disorders - immunology</topic><topic>Lymphoproliferative Disorders - pathology</topic><topic>Lymphoproliferative Disorders - virology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Organ Transplantation - adverse effects</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>NELSON, B. P</creatorcontrib><creatorcontrib>NALESNIK, M. A</creatorcontrib><creatorcontrib>BAHLER, D. W</creatorcontrib><creatorcontrib>LOCKER, J</creatorcontrib><creatorcontrib>FUNG, J. J</creatorcontrib><creatorcontrib>SWERDLOW, S. H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>NELSON, B. P</au><au>NALESNIK, M. A</au><au>BAHLER, D. W</au><au>LOCKER, J</au><au>FUNG, J. J</au><au>SWERDLOW, S. H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epstein-Barr virus-negative post-transplant lymphoproliferative disorders: A distinct entity?</atitle><jtitle>The American journal of surgical pathology</jtitle><addtitle>Am J Surg Pathol</addtitle><date>2000-03-01</date><risdate>2000</risdate><volume>24</volume><issue>3</issue><spage>375</spage><epage>385</epage><pages>375-385</pages><issn>0147-5185</issn><eissn>1532-0979</eissn><coden>AJSPDX</coden><abstract>Post-transplant lymphoproliferative disorders (PTLDs) are usually but not invariably associated with Epstein-Barr virus (EBV). The reported incidence, however, of EBV-negative PTLDs varies widely, and it is uncertain whether they should be considered analogous to EBV-positive PTLDs and whether they have any distinctive features. Therefore, the EBV status of 133 PTLDs from 80 patients was determined using EBV-encoded small ribonucleic acid (EBER) in situ hybridization stains with or without Southern blot EBV terminal repeat analysis. The morphologic, immunophenotypic, genotypic, and clinical features of the EBV-negative PTLDs were reviewed, and selected features were compared with EBV-positive cases. Twenty-one percent of patients had at least one EBV-negative PTLD (14% of biopsies). The initial EBV-negative PTLDs occurred a median of 50 months post-transplantation compared with 10 months for EBV-positive cases. Although only 2% of PTLDs from before 1991 were EBV negative, 23% of subsequent PTLDs were EBV negative (p <0.001). Of the EBV-negative PTLDs, 67% were of monomorphic type (M-PTLD) compared with 42% of EBV-positive cases (p <0.05). The other EBV-negative PTLDs were of infectious mononucleosis-like, plasma cell-rich (n = 2), small B-cell lymphoid neoplasm, large granular lymphocyte disorder (n = 4) and polymorphic (P) types. B-cell clonality was established in 14 specimens and T-cell clonality was established in three (two patients). None of the remaining specimens were studied with Southern blot analysis and some had no ancillary studies. Rearrangement of c-MYC was identified in two M-PTLDs with small noncleaved-like features, and rearrangement of BCL-2 was found in one large noncleaved-like M-PTLD. Ten patients were alive at 3 to 63 months (only three patients received chemotherapy). Seven patients, all with M-PTLDs, are dead at 0.3 to 6 months. Therefore, EBV-negative PTLDs have distinct features, but some do respond to decreased immunosuppression, similar to EBV-positive cases, suggesting that EBV positivity should not be an absolute criterion for the diagnosis of a PTLD.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>10716151</pmid><doi>10.1097/00000478-200003000-00006</doi><tpages>11</tpages></addata></record> |
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| ispartof | The American journal of surgical pathology, 2000-03, Vol.24 (3), p.375-385 |
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| subjects | Adult Aged Biological and medical sciences Female Genotype Hematologic and hematopoietic diseases Herpesvirus 4, Human - genetics Herpesvirus 4, Human - isolation & purification Humans Immunophenotyping Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Lymphoproliferative Disorders - immunology Lymphoproliferative Disorders - pathology Lymphoproliferative Disorders - virology Male Medical sciences Middle Aged Miscellaneous Organ Transplantation - adverse effects Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases |
| title | Epstein-Barr virus-negative post-transplant lymphoproliferative disorders: A distinct entity? |
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