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Review

Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options

by
Michele Clerico
1,
Irene Dogliotti
2,
Andrea Aroldi
3,
Chiara Consoli
1,
Luisa Giaccone
2,
Benedetto Bruno
1 and
Federica Cavallo
1,*
1
Division of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, 10126 Turin, Italy
2
Stem Cell Transplant Unit, A.O.U. Città della Salute e della Scienza di Torino, 10126 Turin, Italy
3
Division of Hematology, Bone Marrow Transplant Unit, University of Milan-Bicocca, Ospedale San Gerardo, 20900 Monza, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2022, 11(24), 7542; https://doi.org/10.3390/jcm11247542
Submission received: 1 December 2022 / Revised: 15 December 2022 / Accepted: 16 December 2022 / Published: 19 December 2022
(This article belongs to the Special Issue Hematopoietic Stem Cell Transplantation: Current Status and Future Research)
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Abstract

Post-transplant lymphoproliferative disease (PTLD) is a serious complication occurring as a consequence of immunosuppression in the setting of allogeneic hematopoietic stem cell transplantation (alloHSCT) or solid organ transplantation (SOT). The majority of PTLD arises from B-cells, and Epstein–Barr virus (EBV) infection is present in 60–80% of the cases, revealing the central role played by the latent infection in the pathogenesis of the disease. Therefore, EBV serological status is considered the most important risk factor associated with PTLDs, together with the depth of T-cell immunosuppression pre- and post-transplant. However, despite the advances in pathogenesis understanding and the introduction of novel treatment options, PTLD arising after alloHSCT remains a particularly challenging disease, and there is a need for consensus on how to treat rituximab-refractory cases. This review aims to explore the pathogenesis, risk factors, and treatment options of PTLD in the alloHSCT setting, finally focusing on adoptive immunotherapy options, namely EBV-specific cytotoxic T-lymphocytes (EBV-CTL) and chimeric antigen receptor T-cells (CAR T).
Keywords: post-transplant lymphoproliferative disease (PTLD); allogeneic hematopoietic stem cell transplantation (alloHSCT); Epstein–Barr virus (EBV) post-transplant lymphoproliferative disease (PTLD); allogeneic hematopoietic stem cell transplantation (alloHSCT); Epstein–Barr virus (EBV)

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MDPI and ACS Style

Clerico, M.; Dogliotti, I.; Aroldi, A.; Consoli, C.; Giaccone, L.; Bruno, B.; Cavallo, F. Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options. J. Clin. Med. 2022, 11, 7542. https://doi.org/10.3390/jcm11247542

AMA Style

Clerico M, Dogliotti I, Aroldi A, Consoli C, Giaccone L, Bruno B, Cavallo F. Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options. Journal of Clinical Medicine. 2022; 11(24):7542. https://doi.org/10.3390/jcm11247542

Chicago/Turabian Style

Clerico, Michele, Irene Dogliotti, Andrea Aroldi, Chiara Consoli, Luisa Giaccone, Benedetto Bruno, and Federica Cavallo. 2022. "Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options" Journal of Clinical Medicine 11, no. 24: 7542. https://doi.org/10.3390/jcm11247542

APA Style

Clerico, M., Dogliotti, I., Aroldi, A., Consoli, C., Giaccone, L., Bruno, B., & Cavallo, F. (2022). Post-Transplant Lymphoproliferative Disease (PTLD) after Allogeneic Hematopoietic Stem Cell Transplantation: Biology and Treatment Options. Journal of Clinical Medicine, 11(24), 7542. https://doi.org/10.3390/jcm11247542

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