Posttransplantation human herpesvirus-8 (HHV8)/Kaposi sarcoma herpesvirus (KSHV) primary infection and/or reactivations are associated with uncommon and sometimes fatal, neoplastic, and non-neoplastic diseases. HHV8-related clinical manifestations notably range from Kaposi sarcoma (KS) to either primary effusion lymphoma or multicentric Castleman disease B-cell malignancies, and from polyclonal HHV8-positive plasmacytic lymphoproliferative disorders to bone marrow failure and peripheral cytopenias, associated or not with hemophagocytic syndromes, and to acute hepatitis syndromes. We reviewed the patient series reported in the literature and summarized clinical management aspects, in terms of diagnosis, follow-up, and treatment. We described typical clinical presentations and histopathologic diagnostic features of these diseases, and we discussed the role of HHV8-specific serologic, molecular, and immunologic assays, particularly focusing on recent data from HHV8-specific T-cell monitoring in posttransplantation KS patients. We finally discussed actual therapeutic options, namely, the reduction or discontinuation of immunosuppressive therapy or the switch from calcineurin inhibitors to mTOR inhibitors, as alternatives to antineoplastic chemotherapy, along with the use of antiherpesvirus agents as prophylactic or therapeutic measures, and treatment with rituximab in posttrans-plantation multicentric Castleman disease patients and non-neoplastic HHV8-associated syndromes.

How I treat HHV8/KSHV-related diseases in posttransplant patients / Riva, Giovanni; Luppi, Mario; Barozzi, Patrizia; Forghieri, Fabio; Potenza, Leonardo. - In: BLOOD. - ISSN 0006-4971. - STAMPA. - 120:(2012), pp. 4150-4159. [10.1182/blood-2012-04-421412]

How I treat HHV8/KSHV-related diseases in posttransplant patients.

RIVA, Giovanni;LUPPI, Mario;BAROZZI, Patrizia;FORGHIERI, Fabio;POTENZA, Leonardo
2012

Abstract

Posttransplantation human herpesvirus-8 (HHV8)/Kaposi sarcoma herpesvirus (KSHV) primary infection and/or reactivations are associated with uncommon and sometimes fatal, neoplastic, and non-neoplastic diseases. HHV8-related clinical manifestations notably range from Kaposi sarcoma (KS) to either primary effusion lymphoma or multicentric Castleman disease B-cell malignancies, and from polyclonal HHV8-positive plasmacytic lymphoproliferative disorders to bone marrow failure and peripheral cytopenias, associated or not with hemophagocytic syndromes, and to acute hepatitis syndromes. We reviewed the patient series reported in the literature and summarized clinical management aspects, in terms of diagnosis, follow-up, and treatment. We described typical clinical presentations and histopathologic diagnostic features of these diseases, and we discussed the role of HHV8-specific serologic, molecular, and immunologic assays, particularly focusing on recent data from HHV8-specific T-cell monitoring in posttransplantation KS patients. We finally discussed actual therapeutic options, namely, the reduction or discontinuation of immunosuppressive therapy or the switch from calcineurin inhibitors to mTOR inhibitors, as alternatives to antineoplastic chemotherapy, along with the use of antiherpesvirus agents as prophylactic or therapeutic measures, and treatment with rituximab in posttrans-plantation multicentric Castleman disease patients and non-neoplastic HHV8-associated syndromes.
2012
120
4150
4159
How I treat HHV8/KSHV-related diseases in posttransplant patients / Riva, Giovanni; Luppi, Mario; Barozzi, Patrizia; Forghieri, Fabio; Potenza, Leonardo. - In: BLOOD. - ISSN 0006-4971. - STAMPA. - 120:(2012), pp. 4150-4159. [10.1182/blood-2012-04-421412]
Riva, Giovanni; Luppi, Mario; Barozzi, Patrizia; Forghieri, Fabio; Potenza, Leonardo
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/958494
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