EBV+ PTLD
Epstein-Barr virus positive post-transplant lymphoproliferative disease (EBV+ PTLD) is a rare, acute, and potentially life-threatening lymphoma that presents challenges in the management of transplant patients.1
There are no EMA- or FDA-approved treatments for EBV+ PTLD. Current treatment approaches include reduction of immunosuppression (RIS), anti-CD20 therapy, and chemotherapy.
EBV+ PTLD after failure of initial treatment can be an aggressive, often deadly disease in which survival can be low, with some patients dying within a few months.2,3
Mechanism of disease of EBV+ PTLD
T-cell suppression plays a significant role in the development of EBV+ PTLD1
Epstein-Barr virus (EBV) is one of the most common human viruses and is associated with more than a dozen malignancies in both hematological and solid tumors.4 EBV is a gamma herpes virus, by which over 90% of the human population is infected.5 Primary infection usually occurs at early age.5
EBV primarily infects B-cells. Primary EBV infection usually occurs prior to adulthood through exposure to saliva or other fluids of an infected individual and results in either asymptomatic infection or symptomatic mononucleosis.5 Following primary infection, EBV establishes a latent infection that persists within memory B-cells at low levels, which results in a lifelong infection that the immune system can usually control but cannot clear.5 In immunocompetent individuals, EBV infection is controlled by a strong immune response of virus-specific and nonspecific T-cells that eliminate the majority of EBV infected B-cells.6
A consequence of EBV infection may include B-cell immortalization.5,7
T-cell suppression plays a significant role in the development of EBV+ PTLD8
Without the T-cells to keep infected cells in check, B-cells may hyperproliferate. In post-transplant patients, immunosuppression may allow for the hyperproliferation of EBV-infected cells, due to reactivation or primary infection, which can lead to EBV+ PTLD.7
Please download a brochure on EBV+ PTLD for more information
SE/EBV/12/22/0001