Epstein-Barr virus-associated T-cell lymphoma in solid organ transplant recipients

Post-transplantation lymphoproliferative diseases (PTLDs) are a heterogenou s group of lymphoid proliferative disorders occurring in transplant patient s. Most PTLDs are B-cell in origin; T-cell PTLDs are seldom reported, and E BV-associated T-cell PTLDs are rare. The first case of a T-cell, non-EBV-as sociated PTLD was first described in a renal allograft recipient in 1987. A total of 40 cases of T-cell PTLDs in solid organ transplant recipients hav e been reported. However, so far only 16 cases of EBV-associated T-cell PTL Ds have been reported in the literature. The sites of occurrence of EBV-ass ociated T-cell PTLDs were in the gastrointestinal tract, lungs, bone marrow , skin, liver and spleen. The pathogenesis of EBV-associated T-cell PTLD is uncertain; it is speculated that the EBV may infect a subset of T-cells th at express the CD21 receptor. The present treatment of EBV-associated T-cel l PTLD consists of surgical removal, reduction or withdrawal of immunosuppr ession and/or radiotherapy and chemotherapy. The prognosis is uncertain, an d the 1-year survival for patients who were followed up for 1 year was 50%. (C) 2001 Editions scientifiques et medicales Elsevier SAS.