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Epstein-Barr Virus-Associated Smooth Muscle Tumor After Kidney Transplantation: A French Multicenter Retrospective Study.
Tardieu, Laurène; Anglicheau, Dany; Sberro-Soussan, Rebecca; Lemoine, Mathilde; Golbin, Léonard; Fourdinier, Ophélie; Bruneau, Julie; Charbit, Marina; Meatchi, Tchao; Serre, Jean-Emmanuel; Le Quintrec, Moglie; Karras, Alexandre; Thervet, Eric; Lazareth, Hélène.
Afiliação
  • Tardieu L; Service de Néphrologie et Hémodialyse, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France.
  • Anglicheau D; Service de Transplantation rénale, Hôpital Universitaire Necker-Enfants-Malades, AP-HP, Université Paris Cité, Paris, France.
  • Sberro-Soussan R; Service de Transplantation rénale, Hôpital Universitaire Necker-Enfants-Malades, AP-HP, Université Paris Cité, Paris, France.
  • Lemoine M; Service de Néphrologie, CHU de Rouen, Rouen, France.
  • Golbin L; Service de Néphrologie, CHU de Rennes, Rennes, France.
  • Fourdinier O; Service de Néphrologie et Transplantation rénale, CHU d'Amiens, Amiens, France.
  • Bruneau J; Service d'Anatomopathologie, Hôpital Universitaire Necker-Enfants-Malades, AP-HP, Université Paris Cité, Paris, France.
  • Charbit M; Service de Néphrologie Pédiatrique, Hôpital Universitaire Necker-Enfants-Malades, AP-HP, Université Paris Cité, Paris, France.
  • Meatchi T; Service d'Anatomopathologie, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France.
  • Serre JE; Service de Néphrologie Transplantation, Université de Montpellier, Montpellier, France.
  • Le Quintrec M; Service de Néphrologie Transplantation, Université de Montpellier, Montpellier, France.
  • Karras A; Service de Néphrologie et Hémodialyse, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France.
  • Thervet E; Service de Néphrologie et Hémodialyse, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France.
  • Lazareth H; Service de Néphrologie et Hémodialyse, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France.
Clin Transplant ; 38(8): e15424, 2024 Aug.
Article em En | MEDLINE | ID: mdl-39136236
ABSTRACT

BACKGROUND:

Epstein-Barr virus (EBV) is a herpesvirus linked to nine different human tumors and lymphoproliferative disorders. Immunosuppression promotes EBV-driven malignancies. The most frequent EBV-induced malignancies are lymphomas and nasopharyngeal carcinoma. By promoting smooth muscle proliferation, EBV can induce EBV-associated smooth muscle tumors (EBV-SMT). EBV-SMT is a rare oncological entity for which no current guideline for diagnosis or management exists. Data on posttransplant EBV-SMT (PT-SMT) are scarce in kidney transplant recipients.

METHODS:

We conducted a national multicentric retrospective study and collected cases among transplantation centers in France. Kidney transplant recipients experiencing histologically proven PT-SMT were included. We collected data on demographic characteristics of patient, history of kidney transplantation, history of PT-SMT, evolution of graft function, and patient survival.

RESULTS:

Eight patients were included. The median age at PT-SMT diagnosis was 31 years (range 6.5-40). PT-SMT occurred after a median delay of 37.8 months after transplantation (range 6-175). PT-SMT management consisted in immunosuppressive regimen minimization in all patients. Introduction of mTOR inhibitors was performed in two patients. Four patients (50%) needed chemotherapy. Surgical resection was performed in four patients. At last follow-up after PT-SMT diagnosis (median 33 months (range 17-132)), five patients were considered in complete remission, and two patients had died. Two patients experienced graft rejection; two resumed dialysis (25%). All patients with available data presented with impaired graft function at last follow-up.

CONCLUSION:

PT-SMT is a subacute and progressive disease during kidney transplantation. Even if the risk of developing PT-SMT is low in kidney transplant recipients (0.07% in our cohort), PT-SMT is associated with significant graft loss, possibly due to reduced immunosuppression. Developing guidelines could help transplantation teams better manage these patients.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Transplante de Rim / Tumor de Músculo Liso / Herpesvirus Humano 4 / Infecções por Vírus Epstein-Barr Limite: Adolescent / Adult / Child / Female / Humans / Male País/Região como assunto: Europa Idioma: En Revista: Clin Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2024 Tipo de documento: Article País de afiliação: França

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Transplante de Rim / Tumor de Músculo Liso / Herpesvirus Humano 4 / Infecções por Vírus Epstein-Barr Limite: Adolescent / Adult / Child / Female / Humans / Male País/Região como assunto: Europa Idioma: En Revista: Clin Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2024 Tipo de documento: Article País de afiliação: França