title: [Hematologic malignant complications after transplantation].
abstract: Post-transplant hemopathies are a serious complication of organ transplantation. They include several entities: non-hodgkin lymphoma, Hodgkin disease and myeloma. The pathophysiology, clinical and histological features, treatment and evolution of these diseases are different, but share some similarities. Among factors involved in lymphomagenesis, the role of Epstein Barr virus and immunosuppression are central. EBV primo-infection or reactivation together with a deep depression of T-cell immunity is at particular risk of lymphoma development. The clinical expression and outcome of lymphomas are varied. Assays for EBV replication quantification have been developed leading to immunosuppression decreasing and antiviral therapy when the replication increases. Treatment of post-transplant lymphoproliferations consists mainly in immunotherapy and chemotherapy. Hodgkin disease and myeloma are rare after transplantation; their management is close to the one of immunocompetent patients. The recurrence of myeloma, amyloidosis or light chain deposition disease seems frequent after transplantation and only patients with disappearance of monoclonal component should be proposed for transplantation. On the opposite, the risk of recurrence appears lower for Hodgkin disease; therefore the transplantation of patients with a history of Hodgkin disease looks possible.
authors.affiliation: Service de néphrologie-transplantation, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France. sophie.caillard@chru-strasbourg.fr
authors.forename: Sophie
authors.initials: S
authors.lastname: Caillard
authors.forename: Olivier
authors.initials: O
authors.lastname: Imhoff
authors.forename: Bruno
authors.initials: B
authors.lastname: Moulin
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000188:drug therapy; D004854:Herpesvirus 4, Human / Q000472:pathogenicity; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008223:Lymphoma / Q000209:etiology / Q000821:virology; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000517:prevention & control / Q000821:virology; D009101:Multiple Myeloma / Q000209:etiology / Q000821:virology; D011183:Postoperative Complications / Q000209:etiology* / Q000821:virology; D014180:Transplantation; D014412:Tumor Virus Infections / Q000150:complications / Q000188:drug therapy
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents