Current practices on diagnosis, prevention and treatment of post-transplant lymphoproliferative disorder in pediatric patients after solid organ transplantation: Results of ern transplantchild healthcareworking group survey

Alastair Baker; Esteban Frauca Remacha; Juan Torres Canizales; Luz Yadira Bravo-Gallego; Emer Fitzpatrick; Angel Alonso Melgar; Gema Muñoz Bartolo; Luis Garcia Guereta; Esther Ramos Boluda; Yasmina Mozo; Dorota Broniszczak; Wioletta Jarmużek; Piotr Kalicinski; Britta Maecker-Kolhoff; Julia Carlens; Ulrich Baumann; Charlotte Roy; Christophe Chardot; Elisa Benetti; Mara Cananzi; Elisabetta Calore; Luca Dello Strologo; Manila Candusso; Maria Francelina Lopes; Manuel João Brito; Cristina Gonçalves; Carmen Do Carmo; Xavier Stephenne; Lars Wennberg; Rosário Stone; Jelena Rascon; Caroline Lindemans; Dominik Turkiewicz; Eugenia Giraldi; Emanuele Nicastro; Lorenzo D’Antiga; Oanez Ackermann; Paloma Jara Vega

doi:10.3390/children8080661

Current practices on diagnosis, prevention and treatment of post-transplant lymphoproliferative disorder in pediatric patients after solid organ transplantation: Results of ern transplantchild healthcareworking group survey

Alastair Baker, Esteban Frauca Remacha, Juan Torres Canizales, Luz Yadira Bravo-Gallego^*, Emer Fitzpatrick, Angel Alonso Melgar, Gema Muñoz Bartolo, Luis Garcia Guereta, Esther Ramos Boluda, Yasmina Mozo, Dorota Broniszczak, Wioletta Jarmużek, Piotr Kalicinski, Britta Maecker-Kolhoff, Julia Carlens, Ulrich Baumann, Charlotte Roy, Christophe Chardot, Elisa Benetti, Mara CananziElisabetta Calore, Luca Dello Strologo, Manila Candusso, Maria Francelina Lopes, Manuel João Brito, Cristina Gonçalves, Carmen Do Carmo, Xavier Stephenne, Lars Wennberg, Rosário Stone, Jelena Rascon, Caroline Lindemans, Dominik Turkiewicz, Eugenia Giraldi, Emanuele Nicastro, Lorenzo D’Antiga, Oanez Ackermann, Paloma Jara Vega

^*Corresponding author for this work

Inflammation Biology

Research output: Contribution to journal › Article › peer-review

20 Citations (Scopus)

Abstract

(1) Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication of solid organ transplantation (SOT). However, there is lack of consensus in PTLD management. Our aim was to establish a present benchmark for comparison between international centers and between various organ transplant systems and modalities; (2) Methods: A cross-sectional questionnaire of relevant PTLD practices in pediatric transplantation was sent to multidisciplinary teams from 17 European center members of ERN TransplantChild to evaluate the centers’ approach strategies for diagnosis and treatment and how current practices impact a cross-sectional series of PTLD cases; (3) Results: A total of 34 SOT programs from 13 European centers participated. The decision to start preemptive treatment and its guidance was based on both EBV viremia monitoring plus additional laboratory methods and clinical assessment (61%). Among treatment modalities the most common initial practice at diagnosis was to reduce the immunosuppression (61%). A total of 126 PTLD cases were reported during the period 2012-2016. According to their histopathological classification, monomorphic lesions were the most frequent (46%). Graft rejection after PTLD remission was 33%. Of the total cases diagnosed with PTLD, 88% survived; (4) Conclusions: There is still no consensus on prevention and treatment of PTLD, which implies the need to generate evidence. This might successively allow the development of clinical guidelines.

Original language	English
Article number	661
Journal	Children
Volume	8
Issue number	8
DOIs	https://doi.org/10.3390/children8080661
Publication status	Published - Aug 2021

Keywords

Epstein-Barr virus
Immunosuppression
Pediatric
Post-transplant lymphoproliferative disorder
PTLD
Solid organ transplantation

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Baker, A., Remacha, E. F., Canizales, J. T., Bravo-Gallego, L. Y., Fitzpatrick, E., Melgar, A. A., Bartolo, G. M., Guereta, L. G., Boluda, E. R., Mozo, Y., Broniszczak, D., Jarmużek, W., Kalicinski, P., Maecker-Kolhoff, B., Carlens, J., Baumann, U., Roy, C., Chardot, C., Benetti, E., ... Vega, P. J. (2021). Current practices on diagnosis, prevention and treatment of post-transplant lymphoproliferative disorder in pediatric patients after solid organ transplantation: Results of ern transplantchild healthcareworking group survey. Children, 8(8), Article 661. https://doi.org/10.3390/children8080661

@article{b0c8fd3c07744c24bcabbbb95cc6bc59,

title = "Current practices on diagnosis, prevention and treatment of post-transplant lymphoproliferative disorder in pediatric patients after solid organ transplantation: Results of ern transplantchild healthcareworking group survey",

abstract = "(1) Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication of solid organ transplantation (SOT). However, there is lack of consensus in PTLD management. Our aim was to establish a present benchmark for comparison between international centers and between various organ transplant systems and modalities; (2) Methods: A cross-sectional questionnaire of relevant PTLD practices in pediatric transplantation was sent to multidisciplinary teams from 17 European center members of ERN TransplantChild to evaluate the centers{\textquoteright} approach strategies for diagnosis and treatment and how current practices impact a cross-sectional series of PTLD cases; (3) Results: A total of 34 SOT programs from 13 European centers participated. The decision to start preemptive treatment and its guidance was based on both EBV viremia monitoring plus additional laboratory methods and clinical assessment (61%). Among treatment modalities the most common initial practice at diagnosis was to reduce the immunosuppression (61%). A total of 126 PTLD cases were reported during the period 2012-2016. According to their histopathological classification, monomorphic lesions were the most frequent (46%). Graft rejection after PTLD remission was 33%. Of the total cases diagnosed with PTLD, 88% survived; (4) Conclusions: There is still no consensus on prevention and treatment of PTLD, which implies the need to generate evidence. This might successively allow the development of clinical guidelines.",

keywords = "Epstein-Barr virus, Immunosuppression, Pediatric, Post-transplant lymphoproliferative disorder, PTLD, Solid organ transplantation",

author = "Alastair Baker and Remacha, {Esteban Frauca} and Canizales, {Juan Torres} and Bravo-Gallego, {Luz Yadira} and Emer Fitzpatrick and Melgar, {Angel Alonso} and Bartolo, {Gema Mu{\~n}oz} and Guereta, {Luis Garcia} and Boluda, {Esther Ramos} and Yasmina Mozo and Dorota Broniszczak and Wioletta Jarmu{\.z}ek and Piotr Kalicinski and Britta Maecker-Kolhoff and Julia Carlens and Ulrich Baumann and Charlotte Roy and Christophe Chardot and Elisa Benetti and Mara Cananzi and Elisabetta Calore and {Dello Strologo}, Luca and Manila Candusso and Lopes, {Maria Francelina} and Brito, {Manuel Jo{\~a}o} and Cristina Gon{\c c}alves and {Do Carmo}, Carmen and Xavier Stephenne and Lars Wennberg and Ros{\'a}rio Stone and Jelena Rascon and Caroline Lindemans and Dominik Turkiewicz and Eugenia Giraldi and Emanuele Nicastro and Lorenzo D{\textquoteright}Antiga and Oanez Ackermann and Vega, {Paloma Jara}",

note = "Funding Information: Funding: This study has been supported by the European Reference Network on pediatric Transplantation (ERN TransplantChild), which is partly cofounded by the European Union within the framework of the Third Health Programme ERN. Specific Agreement Number: 847103. Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = aug,

doi = "10.3390/children8080661",

language = "English",

volume = "8",

journal = "Children",

issn = "2227-9067",

publisher = "MDPI",

number = "8",

}

Baker, A, Remacha, EF, Canizales, JT, Bravo-Gallego, LY, Fitzpatrick, E, Melgar, AA, Bartolo, GM, Guereta, LG, Boluda, ER, Mozo, Y, Broniszczak, D, Jarmużek, W, Kalicinski, P, Maecker-Kolhoff, B, Carlens, J, Baumann, U, Roy, C, Chardot, C, Benetti, E, Cananzi, M, Calore, E, Dello Strologo, L, Candusso, M, Lopes, MF, Brito, MJ, Gonçalves, C, Do Carmo, C, Stephenne, X, Wennberg, L, Stone, R, Rascon, J, Lindemans, C, Turkiewicz, D, Giraldi, E, Nicastro, E, D’Antiga, L, Ackermann, O & Vega, PJ 2021, 'Current practices on diagnosis, prevention and treatment of post-transplant lymphoproliferative disorder in pediatric patients after solid organ transplantation: Results of ern transplantchild healthcareworking group survey', Children, vol. 8, no. 8, 661. https://doi.org/10.3390/children8080661

Current practices on diagnosis, prevention and treatment of post-transplant lymphoproliferative disorder in pediatric patients after solid organ transplantation: Results of ern transplantchild healthcareworking group survey. / Baker, Alastair; Remacha, Esteban Frauca; Canizales, Juan Torres et al.
In: Children, Vol. 8, No. 8, 661, 08.2021.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Current practices on diagnosis, prevention and treatment of post-transplant lymphoproliferative disorder in pediatric patients after solid organ transplantation

T2 - Results of ern transplantchild healthcareworking group survey

AU - Baker, Alastair

AU - Remacha, Esteban Frauca

AU - Canizales, Juan Torres

AU - Bravo-Gallego, Luz Yadira

AU - Fitzpatrick, Emer

AU - Melgar, Angel Alonso

AU - Bartolo, Gema Muñoz

AU - Guereta, Luis Garcia

AU - Boluda, Esther Ramos

AU - Mozo, Yasmina

AU - Broniszczak, Dorota

AU - Jarmużek, Wioletta

AU - Kalicinski, Piotr

AU - Maecker-Kolhoff, Britta

AU - Carlens, Julia

AU - Baumann, Ulrich

AU - Roy, Charlotte

AU - Chardot, Christophe

AU - Benetti, Elisa

AU - Cananzi, Mara

AU - Calore, Elisabetta

AU - Dello Strologo, Luca

AU - Candusso, Manila

AU - Lopes, Maria Francelina

AU - Brito, Manuel João

AU - Gonçalves, Cristina

AU - Do Carmo, Carmen

AU - Stephenne, Xavier

AU - Wennberg, Lars

AU - Stone, Rosário

AU - Rascon, Jelena

AU - Lindemans, Caroline

AU - Turkiewicz, Dominik

AU - Giraldi, Eugenia

AU - Nicastro, Emanuele

AU - D’Antiga, Lorenzo

AU - Ackermann, Oanez

AU - Vega, Paloma Jara

N1 - Funding Information: Funding: This study has been supported by the European Reference Network on pediatric Transplantation (ERN TransplantChild), which is partly cofounded by the European Union within the framework of the Third Health Programme ERN. Specific Agreement Number: 847103. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/8

Y1 - 2021/8

N2 - (1) Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication of solid organ transplantation (SOT). However, there is lack of consensus in PTLD management. Our aim was to establish a present benchmark for comparison between international centers and between various organ transplant systems and modalities; (2) Methods: A cross-sectional questionnaire of relevant PTLD practices in pediatric transplantation was sent to multidisciplinary teams from 17 European center members of ERN TransplantChild to evaluate the centers’ approach strategies for diagnosis and treatment and how current practices impact a cross-sectional series of PTLD cases; (3) Results: A total of 34 SOT programs from 13 European centers participated. The decision to start preemptive treatment and its guidance was based on both EBV viremia monitoring plus additional laboratory methods and clinical assessment (61%). Among treatment modalities the most common initial practice at diagnosis was to reduce the immunosuppression (61%). A total of 126 PTLD cases were reported during the period 2012-2016. According to their histopathological classification, monomorphic lesions were the most frequent (46%). Graft rejection after PTLD remission was 33%. Of the total cases diagnosed with PTLD, 88% survived; (4) Conclusions: There is still no consensus on prevention and treatment of PTLD, which implies the need to generate evidence. This might successively allow the development of clinical guidelines.

AB - (1) Background: Post-transplant lymphoproliferative disease (PTLD) is a significant complication of solid organ transplantation (SOT). However, there is lack of consensus in PTLD management. Our aim was to establish a present benchmark for comparison between international centers and between various organ transplant systems and modalities; (2) Methods: A cross-sectional questionnaire of relevant PTLD practices in pediatric transplantation was sent to multidisciplinary teams from 17 European center members of ERN TransplantChild to evaluate the centers’ approach strategies for diagnosis and treatment and how current practices impact a cross-sectional series of PTLD cases; (3) Results: A total of 34 SOT programs from 13 European centers participated. The decision to start preemptive treatment and its guidance was based on both EBV viremia monitoring plus additional laboratory methods and clinical assessment (61%). Among treatment modalities the most common initial practice at diagnosis was to reduce the immunosuppression (61%). A total of 126 PTLD cases were reported during the period 2012-2016. According to their histopathological classification, monomorphic lesions were the most frequent (46%). Graft rejection after PTLD remission was 33%. Of the total cases diagnosed with PTLD, 88% survived; (4) Conclusions: There is still no consensus on prevention and treatment of PTLD, which implies the need to generate evidence. This might successively allow the development of clinical guidelines.

KW - Epstein-Barr virus

KW - Immunosuppression

KW - Pediatric

KW - Post-transplant lymphoproliferative disorder

KW - PTLD

KW - Solid organ transplantation

UR - http://www.scopus.com/inward/record.url?scp=85112779549&partnerID=8YFLogxK

U2 - 10.3390/children8080661

DO - 10.3390/children8080661

M3 - Article

AN - SCOPUS:85112779549

SN - 2227-9067

VL - 8

JO - Children

JF - Children

IS - 8

M1 - 661

ER -

Current practices on diagnosis, prevention and treatment of post-transplant lymphoproliferative disorder in pediatric patients after solid organ transplantation: Results of ern transplantchild healthcareworking group survey

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Keywords

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