The role of immunosuppression in lymphoma.
Post-transplant lymphoproliferative disorder (PTLD) is a well-recognized yet serious complication in solid organ transplant recipients and currently represents the second most common de novo malignancy following solid organ transplantation. PTLD has been noted in all transplant immunosuppressive eras including the pre-cyclosporine, cyclosporine, and post-cyclosporine eras. The time from organ transplantation to PTLD presentation varies widely from less than 1 month to several years. PTLD presents with a broad spectrum of clinical manifestations depending on the transplanted organ, immunosuppressive therapy and patient age. Intense immunosuppressive therapy is a major risk factor for development of PTLD. Whenever a new agent is introduced, there is a learning curve that leads to dosing modifications, which in turn result in optimization of its immunosuppressive efficacy and reduction of toxicities, including PTLD. We review the major historical and recent immunosuppression trials to assess the impact of individual immunosuppressive agents and regimens on PTLD risk.
Trofe
Jennifer
J
Department of Surgery, University of Cincinnati, OH 45267-0558, USA.
Buell
Joseph F
JF
First
M Roy
MR
Hanaway
Michael J
MJ
Beebe
Tom M
TM
Woodle
E Steve
ES
D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008223:Lymphoma / Q000188:drug therapy* / Q000209:etiology; D016377:Organ Transplantation / Q000009:adverse effects
D007166:Immunosuppressive Agents