Cellular immunity to Epstein-Barr virus in liver transplant recipients treated with Rituximab for post-transplant lymphoproliferative disease

Barbara Savoldo, Cliona M. Rooney, Ruben E. Quiros-Tejeira, Yvette Caldwell, Hans Joachim Wagner, Timothy Lee, Milton J. Finegold, Gianpietro Dotti, Helen E. Heslop, John A. Goss

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

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/μg DNA at diagnosis. Four to eight months after Rituximab, EBV-load increased (>4000 copies/μg 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.

Original languageEnglish (US)
Pages (from-to)566-572
Number of pages7
JournalAmerican Journal of Transplantation
Volume5
Issue number3
DOIs
StatePublished - Mar 1 2005

Fingerprint

Human Herpesvirus 4
Cellular Immunity
Transplants
Liver
T-Lymphoid Precursor Cells
Immunocompetence
Rituximab
Transplant Recipients
DNA
Real-Time Polymerase Chain Reaction
B-Lymphocytes
Monoclonal Antibodies
Pediatrics
T-Lymphocytes
Therapeutics

Keywords

  • EBV
  • Liver transplant
  • PTLD
  • Rituximab

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Cellular immunity to Epstein-Barr virus in liver transplant recipients treated with Rituximab for post-transplant lymphoproliferative disease. / Savoldo, Barbara; Rooney, Cliona M.; Quiros-Tejeira, Ruben E.; Caldwell, Yvette; Wagner, Hans Joachim; Lee, Timothy; Finegold, Milton J.; Dotti, Gianpietro; Heslop, Helen E.; Goss, John A.

In: American Journal of Transplantation, Vol. 5, No. 3, 01.03.2005, p. 566-572.

Research output: Contribution to journalArticle

Savoldo, Barbara ; Rooney, Cliona M. ; Quiros-Tejeira, Ruben E. ; Caldwell, Yvette ; Wagner, Hans Joachim ; Lee, Timothy ; Finegold, Milton J. ; Dotti, Gianpietro ; Heslop, Helen E. ; Goss, John A. / Cellular immunity to Epstein-Barr virus in liver transplant recipients treated with Rituximab for post-transplant lymphoproliferative disease. In: American Journal of Transplantation. 2005 ; Vol. 5, No. 3. pp. 566-572.
@article{8fa2320ad9f44ba6a9f9efb09ce1e729,
title = "Cellular immunity to Epstein-Barr virus in liver transplant recipients treated with Rituximab for post-transplant lymphoproliferative disease",
abstract = "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/μg DNA at diagnosis. Four to eight months after Rituximab, EBV-load increased (>4000 copies/μg 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.",
keywords = "EBV, Liver transplant, PTLD, Rituximab",
author = "Barbara Savoldo and Rooney, {Cliona M.} and Quiros-Tejeira, {Ruben E.} and Yvette Caldwell and Wagner, {Hans Joachim} and Timothy Lee and Finegold, {Milton J.} and Gianpietro Dotti and Heslop, {Helen E.} and Goss, {John A.}",
year = "2005",
month = "3",
day = "1",
doi = "10.1111/j.1600-6143.2004.00693.x",
language = "English (US)",
volume = "5",
pages = "566--572",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Cellular immunity to Epstein-Barr virus in liver transplant recipients treated with Rituximab for post-transplant lymphoproliferative disease

AU - Savoldo, Barbara

AU - Rooney, Cliona M.

AU - Quiros-Tejeira, Ruben E.

AU - Caldwell, Yvette

AU - Wagner, Hans Joachim

AU - Lee, Timothy

AU - Finegold, Milton J.

AU - Dotti, Gianpietro

AU - Heslop, Helen E.

AU - Goss, John A.

PY - 2005/3/1

Y1 - 2005/3/1

N2 - 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/μg DNA at diagnosis. Four to eight months after Rituximab, EBV-load increased (>4000 copies/μg 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.

AB - 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/μg DNA at diagnosis. Four to eight months after Rituximab, EBV-load increased (>4000 copies/μg 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.

KW - EBV

KW - Liver transplant

KW - PTLD

KW - Rituximab

UR - http://www.scopus.com/inward/record.url?scp=20044361817&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20044361817&partnerID=8YFLogxK

U2 - 10.1111/j.1600-6143.2004.00693.x

DO - 10.1111/j.1600-6143.2004.00693.x

M3 - Article

C2 - 15707412

AN - SCOPUS:20044361817

VL - 5

SP - 566

EP - 572

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 3

ER -