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New approach to post-transplant lymphoma shows promise

COLUMBUS, Ohio - Scientists may be making significant headway in treating one of the most difficult and often fatal complications of organ transplant, PTLD, or post-transplant lymphoproliferative disorder.

PTLD is a form of lymphoma, or cancer of the glands of the lymph system, associated with the presence of the Epstein-Barr virus (EBV). Normally, EBV itself is not threatening - scientists say 90-95 percent of us carry it in our systems all the time. But it poses special problems for transplant patients because the drugs they have to take to keep their body from rejecting new organs weaken the immune system and create the perfect environment for the virus to spring into action.

Kidney transplants are among the most common transplants in the United States, with more than 10,000 renal transplants performed annually for patients with end-stage renal disease. PTLD occurs in 1 to 2 percent of kidney transplants, with mortality ranging from 50 to 70 percent. PTLD may develop following kidney or other organ transplants when EBV-infected B lymphocytes proliferate uncontrollably in the absence of the infection-fighting immune cells that normally keep them in check.

Its a tricky complication to treat successfully.

A multidisciplinary team of physicians and scientists at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute Ohio State University Comprehensive Cancer Center, however, says it has had significant success treating PTLD using a two-part therapy that includes the use of the antiviral drug acyclovir along with gradual reductions in patients immunosuppressive drugs. By reducing the doses of the drugs that suppress the rejection of the transplanted organ and the function of the normal immune system, the immune mediators that recognize and kill EBV-infected cancer cells are allowed to do their job.

Drs. Pierluigi Porcu and Charles Eisenbeis, oncologists at The James, used the approach with 11 consecutive kidney transp
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Contact: Michelle Gailiun
gailiun.1@osu.edu
614-293-3737
Ohio State University Medical Center
12-Jun-2002


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