Tissue polypeptide specific antigen for the detection of lymphoproliferative diseases induced by cyclosporin.
OBJECTIVE
To evaluate the efficacy of tissue polypeptide specific (TPS) antigen for the early detection of cyclosporin A (CyA) induced post-transplant lymphoproliferative diseases.


METHODS
Serum concentrations of TPS antigen were analysed using a monoclonal enzyme immunoassay and whole blood CyA concentrations were measured using high pressure liquid chromatography. Infection with Epstein-Barr virus and cytomegalovirus was detected by determining levels of IgM and IgG antibodies directed against viral capsid antigen (VCA). Immunohistochemistry and analysis of clonality were carried out on formalin fixed, paraffin wax embedded tissue.


RESULTS
The mean serum concentration of TPS antigen in the eight transplant recipients investigated was 60 U/l during periods without complication (control), 101 U/l during infection, 166 U/l when the diagnosis of a lymphoma was confirmed, and 172 U/l when lymphoma and infection coincided. Increased TPS antigen concentrations were detected in six patients one month before detection of malignancy. After reduction of immunosuppression and the start of tumour regression, TPS antigen concentrations decreased. TPS antigen concentrations increased in the one patient who experienced a recurrence.


CONCLUSIONS
Continuous monitoring of TPS antigen concentrations leads to the early discovery of CyA induced lymphoproliferative disease.
Department of Laboratory Diagnostics, Kaiser Franz Josef Hospital, Vienna, Austria.
M
M
Vogl
A
A
Griesmacher
M
M
Grimm
W
W
Klepetko
M M
MM
Müller
D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D016867:Immunocompromised Host; D016040:Lung Transplantation; D008223:Lymphoma / Q000097:blood / Q000175:diagnosis / Q000276:immunology; D008232:Lymphoproliferative Disorders / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood*; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D010455:Peptides; C089984:tissue polypeptide specific antigen; D016572:Cyclosporine