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Cellular Immunity to Epstein‐Barr Virus in Liver Transplant Recipients Treated with Rituximab for Post‐Transplant Lymphoproliferative Disease
Author(s) -
Savoldo Barbara,
Rooney Cliona M.,
QuirosTejeira Ruben E.,
Caldwell Yvette,
Wagner HansJoachim,
Lee Timothy,
Finegold Milton J.,
Dotti Gianpietro,
Heslop Helen E.,
Goss John A.
Publication year - 2005
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2004.00693.x
Subject(s) - rituximab , medicine , elispot , immunology , lymphoproliferative disorders , lymphoma , epstein–barr virus , mononucleosis , virus , immune system , t cell
The evaluation of long‐term cellular immunity to EBV in pediatric orthotopic liver transplant (OLT) recipients after treatment with the humanized anti‐CD20 monoclonal antibody (Rituximab) has not yet been explored. At our institution, one child with EBV‐related mononucleosis‐like syndrome and five children with polymorphic‐EBV‐PTLD occurring 6–88 months after OLT were treated with Rituximab. Treatment was well tolerated. All children achieved complete remission. After Rituximab, B‐lymphocytes were undetectable in the peripheral blood and EBV‐load, monitored with real‐time PCR, decreased to undetectable levels in all children from >4000 copies/μg DNA at diagnosis. Four to eight months after Rituximab, EBV‐load increased (>4000 copies/μg DNA) in four children, and PTLD recurred in three. Their frequency of EBV‐specific T‐cell precursors, measured by Elispot analysis, remained lower than in healthy controls. Rituximab effectively induced regression of PTLD in OLT recipients. However, EBV‐specific T‐cell immunocompetence, which may be crucial for the long‐term control of EBV‐mediated proliferation, did not improve.