切换至 "中华医学电子期刊资源库"

中华移植杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 36 -41. doi: 10.3877/cma.j.issn.1674-3903.2021.01.008

所属专题: 经典病例 文献

经验交流

肾移植术后并发移植后淋巴细胞增殖性疾病一例诊疗分析并文献复习
韦星1, 李响1,(), 陈昌庆1, 金海龙1, 蔡明1   
  1. 1. 100091 北京,解放军总医院第八医学中心器官移植中心泌尿外科
  • 收稿日期:2020-10-26 出版日期:2021-02-25
  • 通信作者: 李响

Diagnosis and treatment of post-transplant lymphoproliferative disorder confined to renal allograft and literature review

Xing Wei1, Xiang Li1,(), Changqing Chen1, Hailong Jin1, Ming Cai1   

  1. 1. Department of Organ Transplantation and Urology, the 8th Medical Center of Chinese People′s Liberation Army General Hospital, Beijing 100091, China
  • Received:2020-10-26 Published:2021-02-25
  • Corresponding author: Xiang Li
引用本文:

韦星, 李响, 陈昌庆, 金海龙, 蔡明. 肾移植术后并发移植后淋巴细胞增殖性疾病一例诊疗分析并文献复习[J]. 中华移植杂志(电子版), 2021, 15(01): 36-41.

Xing Wei, Xiang Li, Changqing Chen, Hailong Jin, Ming Cai. Diagnosis and treatment of post-transplant lymphoproliferative disorder confined to renal allograft and literature review[J]. Chinese Journal of Transplantation(Electronic Edition), 2021, 15(01): 36-41.

图1 2019年8月3日受者移植肾影像学检查结果
表1 累及移植肾的PTLD国内外文献报道
参考文献 病例编号 免疫抑制方案 年龄(岁) 性别 发生距移植时间(月) 临床症状 EB病毒 治疗方案 病理诊断 预后
卢峡等[13] 1 他克莫司+MMF+泼尼松 47 27 移植肾区肿胀 阳性 CHOP 单形性PTLD 随访12年未见复发
  2 环孢素+MMF+泼尼松 52 7 阳性 利妥昔单抗+CHOP 多形性PTLD 随访2年肿物未增大,移植肾功能正常
陈雁扬等[14] 3 环孢素+MMF+泼尼松 42 18 阳性 手术切除 多形性PTLD 随访1年半未复发
王照明等[15] 4 环孢素+MMF+泼尼松 - 6 阴性 手术切除 单形性PTLD 随访4个月后死亡
  5 环孢素+硫唑嘌呤+泼尼松 - 12 阳性 CHOP 单形性PTLD 随访2个月后死亡
宋少伟等[16] 6 环孢素+MMF+泼尼松 52 12 血尿 未知 手术切除 多形性PTLD 随访2个月未发现复发
吴轲等[17] 7 他克莫司+MMF+泼尼松 47 26 移植肾区肿胀 阳性 CHOP 单形性PTLD 随访18个月肿物缩小,移植肾功能正常
Shustik等[18] 8 硫唑嘌呤+泼尼松 45 171 未知 手术切除 单形性PTLD 随访33个月未见复发
Meehan等[19] 9 环孢素+硫唑嘌呤+泼尼松 59 84 阴性 手术切除 单形性PTLD 随访12个月未见复发
  10 环孢素+硫唑嘌呤+泼尼松 14 12 阴性 手术切除 单形性PTLD 随访24个月未见复发
  11 他克莫司+硫唑嘌呤+泼尼松 12 17 阴性 手术切除 单形性PTLD 随访1个月后死亡
Kuppachi等[20] 12 他克莫司+MMF+泼尼松 45 18 阳性 手术切除 单形性PTLD 随访23个月未见复发
Thibaud等[21] 13 他克莫司+MMF+泼尼松 69 36 阳性 RCD 单形性PTLD 随访48个月未见复发
1
刘占祥. 移植后淋巴细胞增殖性疾病诊断进展与治疗规范[J]. 白血病淋巴瘤,2017,26(8):502-505.
2
Kotton CN, Huprikar S, Kumar D. Transplant infectious diseases: a review of the scientific registry of transplant recipients published data[J]. Am J Transplant, 2017, 17(6): 1439-1446.
3
Timuragaoglu A, Ugur-Bilgin A, Colak D, et al. Posttransplant lymphoproliferative disorders in transplant recipients[J]. Transplant Proc, 2006, 38(2): 641-645.
4
Singavi AK, Harington AM, Fenske TS. Post-transplant lymphoproliferative disorders[J]. Cancer Treat Res, 2015, 165: 305-327.
5
Francis A, Johnson DW, Craig J, et al. Post-transplant lymphoproliferative disease may be an adverse risk factor for patient survival but not graft loss in kidney transplant recipients[J]. Kidney Int, 2018, 94(4): 809-817.
6
Akar Özkan E, Özdemir BH, Deniz EE, et al. Posttransplant lymphoproliferative disorder after liver and kidney transplant[J]. Exp Clin Transplant, 2014, 12 (Suppl 1): S142-S148.
7
Dierickx D, Touseyn T, Gheysens O. How treat post-transplant lymphoproliferative disorders[J]. Blood, 2015, 126(20): 2274-2283.
8
Nijland ML, Kersten MJ, Pals ST, et al. Epstein-Barr virus-positive post-transplant lymphoproliferative disease after solid organ transplantation: pathogenesis, clinical manifestations,diagnosis and management[J].Transplant Direct, 2015, 15, 2(1): e48.
9
Engels EA, Pfeiffer RM, Fraumeni JF Jr, et al. Spectrum of cancer risk among US solid organ transplant recipients[J]. JAMA,2011,306(17):1891-1901.
10
Gwon JG, Kim YH, Han DJ. Different causes of early and late-onset post transplant lymphoproliferative disorder in kidney transplantation patients after 2000[J]. Asian J Surg, 2018, 42(4): 551-556.
11
Ready E, Chernushkin K, Partovi N, et al. Post-transplant lymphoproliferative disorder in adults receiving kidney transplantation in britishcolumbia: a retrospective cohort analysis[J]. Can J Kidney Health Dis, 2018, 5: 2054358118760831.
12
Dierickx D, Habermann TM. Post-transplantation lymphoproliferative disorders in adults[J]. N Engl J Med, 2018, 378(6): 549-562.
13
卢峡,郭晖,明长生,等. 肾移植术后淋巴细胞增殖性疾病三例报道[J]. 中华器官移植杂志,2018, 39(9): 559-561.
14
陈雁扬,陈国栋,王珏,等. 肾移植术后淋巴组织增生性疾病一例报告暨文献复习[J]. 中华肾脏病杂志,2018, 34 (1): 24-29.
15
王照明,郑树森,丁伟,等. 移植后淋巴增生性疾病六例临床病理分析[J]. 中华血液学杂志,2007, 28(8): 514-518.
16
宋少伟,张佳林,吴刚,等. 肾移植术后淋巴增生性疾病的诊治二例[J]. 中华器官移植杂志,2007, 28(11): 696-697.
17
吴轲,宫念樵,明长生,等. 肾移植术后发生淋巴细胞增生性疾病一例[J]. 中华器官移植杂志,2007, 28(12): 758.
18
Shustik C, Jamison BM, Alfieri C, et al. A solitary plasma-cytoma of donor origin arising 14 years after kidney allotransplantation[J]. Br J Haematol, 1995,91(1):167-168.
19
Meehan SM, Domer P, Josephson M, et al. The clinical and pathologic implications of plasmacytic infiltrates in percutaneous renal allograft biopsies[J]. Hum Pathol, 2001, 32(2):205-215.
20
Kuppachi S, Naina HV, Self S, et al. Plasmacytoma-like post-transplantation lymphoproliferative disorder confined to the renal allograft: a case report[J]. Transplant Proc, 2013, 45(7):2791-2794.
21
Thibaud V, Rivalan J, Llamas F, et al. Plasmacytoma-like post-kidney-transplant lymphoproliferative disorder confined to renal allograft and urinary tract: a case report[J]. Ne phrol Ther, 2018, 14(7): 544-547.
22
Crane GM, Powell H, Kostadinov R, et al. Primary CNS lymphoproliferative disease, mycophenolate and calcineurin inhibitor usage[J]. Oncotarget, 2015, 6(32): 33849-33866.
23
Morscio J, Tousseyn T. Recent insights in the pathogenesis of post-transplantation lymphoproliferative disorders[J]. World J Transplant, 2016, 6(3): 505-516.
24
Susanne WL, Jenny KL, Hansson S, et al. Long-lasting chronic high load carriage of Epstein-Barr virus is more common in young pediatric renal transplant recipients[J]. Pediatr Nephrol, 2020, 35(3): 427-439.
25
Lee KF, Tsai YT, Lin CY, et al. Cancer incidence among heart, kidney, and liver transplant recipients in Taiwan[J]. PLoS One, 2016, 11 (5): e0155602
26
Sebelin-Wulf K, Nguyen TD, Oertel S, et al. Quantitative analysis of EBV-specific CD4/CD8 T cell numbers absolute CD4/CD8 T cell numbers and EBV load in solid organ transplant recipients with PLTD[J]. Transpl Immunol,2007,17(3):203-210.
27
Ruf S, Behnke-Hall K, Gruhn B, et al. Comparison of six different specimen types for Epstein-Barr viral load quantification in peripheral blood of pediatric patients after heart transplantation or after allogeneic hematopoietic stem cell transplantation[J]. J Clin Virol, 2012, 53(3): 186-194.
28
Doak PB, Montgomerie JZ, North JD, et al. Reticulum cell sarcoma after renal homotransplantation and azathioprine and prednisone therapy[J]. R Med J,1968,21(4):746-768.
29
Zelenetz AD, Gordon LI, Abramson JS, et al. NCCN guidelines insights: B-cell lymphomas, version 3.2019[J]. J Natl Compr Canc Netw, 2019, 17(6):650-661.
30
Taylor E, Jones M, Hourigan MJ, et al. Cesation of immunosuppression duringchemotherapyfor post-transplant lymphoproliferative disorders in renal transplant patients[J]. Nephrol Dial Transplant, 2015, 30(10): 1774-1779.
31
Kanzelmeyer NK, Maecker-Kolhoff B, Zierhut H, et al. Graft outcomes following diagnosis of posttransplant lymphoproliferative disease in pediatric kidney recipients: a retrospective study[J]. Transpl Int, 2018, 31(4): 367-376.
32
EBPG Expert Group on Renal Transplantation. European best practice guidelines for renal transplantation. Section IV: Long-term management of the transplant recipient. IV.6.1. Cancer risk after renal transplantation. Post-transplant lymphoproliferative disease (PTLD): prevention and treatment[J]. Nephrol Dial Transplant, 2002,17 (Suppl 4): S31-S33, S35-S36.
33
Li X, Cui Y, Sun Z, et al. DDGP versus SMILE in newly diagnosed advanced natural killer/T-cell lymphoma: a randomized controlled,muhicenter,open-label study in China[J]. Clin Cancer Res, 2016, 22(21): 5223-5228.
34
Shi Y, Jia B, Xu W, et al.Chidamide in relapsed or refractory peripheral T cell lymphoma:amuhieenter real-world study in China[J]. J Hematol Oncol, 2017, 15, 10(1):69.
35
Francis A, Johnson DW, Craig J,et al. Post-transplant lymphoproliferative disease may be an adverse risk factor for patient survival but not graft loss in kidney transplant recipients[J]. Kidney Int,2018, 94(4): 809-817.
36
Morton M, Coupes B, Ritchie J, et al.Post-transplant lymphoproliferative disorder in adult renal transplant recipients:survival and prognosis[J]. Leuk Lymphoma, 2016, 57(2): 299-305.
37
Montanari F, Radeski D, Seshan V, et al. Recursive partitioning analysis of prognostic factors in post-transplant lymphoproliferative disorders (PTLD): a 120 case single institution series[J]. Br J Haematol, 2015, 171(4): 491-500.
38
Trappe RU, Choquet S, Dierickx D, et al. International pognostic index, type of transplant and response to rituximab are key parameters to tailor treatment in adults with CD20-Positive B cell PTLD:clues from the PTLD-1 trial[J]. Am J Transplant, 2015, 15(4): 1091-1100.
[1] 杨水华, 何桂丹, 覃桂灿, 梁蒙凤, 罗艳合, 李雪芹, 唐娟松. 胎儿孤立性完全型肺静脉异位引流的超声心动图特征及高分辨率血流联合时间-空间相关成像的应用[J]. 中华医学超声杂志(电子版), 2023, 20(10): 1061-1067.
[2] 衣晓丽, 胡沙沙, 张彦. HER-2低表达对乳腺癌新辅助治疗疗效及预后的影响[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 340-346.
[3] 中华医学会骨科学分会关节外科学组, 广东省医学会骨质疏松和骨矿盐疾病分会, 广东省佛山市顺德区第三人民医院. 中国髋部脆性骨折术后抗骨质疏松药物临床干预指南(2023年版)[J]. 中华关节外科杂志(电子版), 2023, 17(06): 751-764.
[4] 许正文, 李振, 侯振扬, 苏长征, 朱彪. 富血小板血浆联合植骨治疗早期非创伤性股骨头坏死[J]. 中华关节外科杂志(电子版), 2023, 17(06): 773-779.
[5] 李培杰, 乔永杰, 张浩强, 曾健康, 谭飞, 李嘉欢, 王静, 周胜虎. 细菌培养阴性的假体周围感染诊治的最新进展[J]. 中华关节外科杂志(电子版), 2023, 17(06): 827-833.
[6] 江泽莹, 王安婷, 王姣丽, 陈慈, 周秋玲, 黄燕娟, 周芳, 薛琰, 周剑烽, 谭文勇, 杜美芳. 多种植物油组分预防肿瘤放化疗相关毒性反应的效果分析[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 523-527.
[7] 朴广昊, 李屹洲, 刘瑞, 赵建民, 王凌峰. 皮肤撕脱伤撕脱皮瓣活力早期评估与修复的研究进展[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 528-532.
[8] 彭旭, 邵永孚, 李铎, 邹瑞, 邢贞明. 结肠肝曲癌的诊断和外科治疗[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 108-110.
[9] 马伟强, 马斌林, 吴中语, 张莹. microRNA在三阴性乳腺癌进展中发挥的作用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 111-114.
[10] 陈垚, 徐伯群, 高志慧. 改良式中间上入路根治术治疗甲状腺癌的有效性安全性研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 619-622.
[11] 袁媛, 赵良平, 刘智慧, 张丽萍, 谭丽梅, 閤梦琴. 子宫内膜癌组织中miR-25-3p、PTEN的表达及与病理参数的关系[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1016-1020.
[12] 陆志峰, 周佳佳, 梁舒. 虚拟现实技术在治疗弱视中的临床应用研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 891-895.
[13] 李田, 徐洪, 刘和亮. 尘肺病的相关研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 900-905.
[14] 岳瑞雪, 孔令欣, 郝鑫, 杨进强, 韩猛, 崔国忠, 王建军, 张志生, 孔凡庭, 张维, 何文博, 李现桥, 周新平, 徐东宏, 胡崇珠. 乳腺癌HER2蛋白表达水平预测新辅助治疗疗效的真实世界研究[J]. 中华临床医师杂志(电子版), 2023, 17(07): 765-770.
[15] 周婷, 孙培培, 张二明, 安欣华, 向平超. 北京市石景山区40岁及以上居民慢性阻塞性肺疾病诊断现状调查[J]. 中华临床医师杂志(电子版), 2023, 17(07): 790-797.
阅读次数
全文


摘要