Evidence map›Paper›PMID 38682750›Full record

ArticlePediatric transplantation2024

Epstein-Barr virus-associated post-transplant lymphoproliferative disorders in pediatric transplantation: A prospective multicenter study in the United States.

Tetsuya Tajima, Olivia M Martinez, Daniel Bernstein, Scott D Boyd, Dita Gratzinger, Grant Lum, Kazunari Sasaki, Brent Tan, Clare J Twist, Kenneth Weinberg and 9 more

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric transplantation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02182986 (Biomarkers for Post-Transplant Lymphoproliferative Disorders in Children), which is not on this map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02182986 completednot on this map

Biomarkers for Post-Transplant Lymphoproliferative Disorders in Children (CTOTC-06)

TypeobservationalSponsorNational Institute of Allergy and Infectious Diseases (NIAID)Ran2014 to 2019Enrolled944ConditionsHeart Transplant, Small Intestine Transplant, Kidney Transplant, Liver TransplantArmstransplant, Immunosuppressive Drugs
3 · Its place in the literature

Who cites it

13 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Observational
  6. Review
  7. Review
  8. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Tetsuya TajimaDivision of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.ORCID 0000-0002-6538-7408
Olivia M MartinezDivision of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.
Daniel BernsteinDepartment of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
Scott D BoydDepartment of Pathology, Stanford University School of Medicine, Stanford, California, USA.
Dita GratzingerDepartment of Pathology, Stanford University School of Medicine, Stanford, California, USA.ORCID 0000-0002-9182-8123
Grant LumDivision of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.
Kazunari SasakiDivision of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.
Brent TanDepartment of Pathology, Stanford University School of Medicine, Stanford, California, USA.
Clare J TwistDepartment of Pediatric Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
Kenneth WeinbergDepartment of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
Brian ArmstrongRho Federal Systems Division, Rho, Durham, North Carolina, USA.
Dev M DesaiDivision of Surgical Transplantation, University of Texas (UT) Southwestern Medical Center, Dallas, Texas, USA.
George V MazariegosDepartment of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children's Hospital, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-2624-8632
Clifford ChinDepartment of Pediatrics and Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio, USA.
Thomas M FishbeinDepartment of Surgery and Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA.
Akin TekinDepartment of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Robert S VenickDepartment of Pediatric Gastroenterology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.ORCID 0000-0002-0956-3147
Sheri M KramsDivision of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.
Carlos O EsquivelDivision of Abdominal Transplantation, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.

Funding

Transplantation GroupUM2AI117870 · NIAID · RHO FEDERAL SYSTEMS DIVISION, INC. · PI DAVID, GLORIA · 2015 to 2023
$208.1M
Biomarkers for Post-Transplant Lymphoproliferative Disorders in ChildrenU01AI104342 · NIAID · STANFORD UNIVERSITY · PI ESQUIVEL, CARLOS O · 2013 to 2018
$7.7M
RhoFED T-SCCCU01AI178768 · NIAID · RHO FEDERAL SYSTEMS DIVISION, INC. · PI ARMSTRONG, BRIAN · 2023 to 2023
$1.5M
National Institute of Allergy and Infectious Diseases of the National Institutes of Health UO1 AI104342NIAID NIH HHS U01 AI104342NIAID NIH HHS U01 AI178768NIAID NIH HHS UM2 AI117870Rho Federal Systems UM2AI117870The Transplant and Tissue Engineering Center at Stanford Children's
6 · The paper itself

Abstract

backgroundEpstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorders (PTLD) is the most common malignancy in children after transplant; however, difficulties for early detection may worsen the prognosis.

methodsThe prospective, multicenter, study enrolled 944 children (≤21 years of age). Of these, 872 received liver, heart, kidney, intestinal, or multivisceral transplants in seven US centers between 2014 and 2019 (NCT02182986). In total, 34 pediatric EBV+ PTLD (3.9%) were identified by biopsy. Variables included sex, age, race, ethnicity, transplanted organ, EBV viral load, pre-transplant EBV serology, immunosuppression, response to chemotherapy and rituximab, and histopathological diagnosis.

resultsThe uni-/multivariable competing risk analyses revealed the combination of EBV-seropositive donor and EBV-naïve recipient (D+R-) was a significant risk factor for PTLD development (sub-hazard ratio: 2.79 [1.34-5.78], p = .006) and EBV DNAemia (2.65 [1.72-4.09], p < .001). Patients with D+R- were significantly more associated with monomorphic/polymorphic PTLD than those with the other combinations (p = .02). Patients with monomorphic/polymorphic PTLD (n = 21) had significantly more EBV DNAemia than non-PTLD patients (p < .001) and an earlier clinical presentation of PTLD than patients with hyperplasias (p < .001), within 6-month post-transplant. Among non-liver transplant recipients, monomorphic/polymorphic PTLD were significantly more frequent than hyperplasias in patients ≥5 years of age at transplant (p = .01).

conclusionsD+R- is a risk factor for PTLD and EBV DNAemia and associated with the incidence of monomorphic/polymorphic PTLD. Intensive follow-up of EBV viral load within 6-month post-transplant, especially for patients with D+R- and/or non-liver transplant recipients ≥5 years of age at transplant, may help detect monomorphic/polymorphic PTLD early in pediatric transplant.

Indexed as

Epstein-Barr Virus InfectionsLymphoproliferative DisordersOrgan TransplantationPostoperative ComplicationsAdolescentChildChild, PreschoolFemaleHerpesvirus 4, HumanHumansInfantMaleProspective StudiesRisk FactorsUnited StatesYoung AdultEpstein–Barr viruspediatric transplantationPTLD

Identifiers

PMID38682750
PMCPMC11115376

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.