title: [Post-transplantation lymphoproliferative disorder in childhood].
abstract: BACKGROUND
  Among possible complications of transplantation the post-transplant lymphoproliferative disease due to immunosuppressive therapy is of paramount importance. In most cases the direct modulating effect of Epstein-Barr virus on immune cells can be documented.
  
  
  OBJECTIVE
  The aim of the authors was to evaluate the incidence os post-transplant lymphoproliferative diseases in pediatric transplant patients in Hungary.
  
  
  METHODS
  The study group included kidney, liver and lung transplant children followed up at the 1st Department of Pediatrics, Semmelweis University, Budapest and stem cell transplant children at Szent László Hospital, Budapest. Data were collected from 78 kidney, 109 liver and 17 lung transplant children as well as from 243 children who underwent allogenic stem cell transplantation.
  
  
  RESULTS
  Between 1998 and 2012, 13 children developed post-transplant lymphoproliferative disorder (8 solid organ transplanted and 5 stem cell transplanted children). The diagnosis was based on histological findings in all cases. Mortality was 3 out of the 8 solid organ transplant children and 4 out of the 5 stem cell transplant children. The highest incidence was observed among lung transplant children (17.6%).
  
  
  CONCLUSIONS
  These data indicate that post-transplant lymphoproliferative disease is a rare but devastating complication of transplantation in children. The most important therapeutic approaches are reduction of immunosuppressive therapy, chemotherapy and rituximab. Early diagnosis may improve clinical outcome and, therefore, routine polymerase chain reaction screening for Epstein-Barr virus of high risk patients is recommended.
authors.affiliation: Egyesített Szt. István és Szt. László Kórház Gyermekhematológiai és Őssejt-transzplantációs Osztály Budapest.
authors.forename: Anita
authors.initials: A
authors.lastname: Stréhn
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest Bókay J. u. 53. 1083.
authors.forename: László
authors.initials: L
authors.lastname: Szőnyi
authors.affiliation: Egyesített Szt. István és Szt. László Kórház Gyermekhematológiai és Őssejt-transzplantációs Osztály Budapest.
authors.forename: Gergely
authors.initials: G
authors.lastname: Kriván
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest Bókay J. u. 53. 1083.
authors.forename: Lajos
authors.initials: L
authors.lastname: Kovács
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest Bókay J. u. 53. 1083.
authors.forename: György
authors.initials: G
authors.lastname: Reusz
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest Bókay J. u. 53. 1083.
authors.forename: Attila
authors.initials: A
authors.lastname: Szabó
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar II. Gyermekgyógyászati Klinika Budapest.
authors.forename: Imre
authors.initials: I
authors.lastname: Rényi
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar II. Gyermekgyógyászati Klinika Budapest.
authors.forename: Gábor
authors.initials: G
authors.lastname: Kovács
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest Bókay J. u. 53. 1083.
authors.forename: Antal
authors.initials: A
authors.lastname: Dezsőfi
mesh_terms: D000293:Adolescent; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D042241:Early Diagnosis; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D016040:Lung Transplantation / Q000009:adverse effects; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D008297:Male; D016377:Organ Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D016133:Polymerase Chain Reaction; D000069283:Rituximab; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D000069283:Rituximab
keywords: Ebstein–Barr-vírus; Epstein–Barr virus; children; gyermek; malignancy; malignitás; post-transplant lymphoproliferative disease; poszttranszplantációs lymphoproliferativ betegség; transplantation; transzplantáció
vernacular_title: Poszttranszplantációs lymphoproliferativ betegség gyermekkorban.