The role of EBV in post-transplant malignancies: a review.

Post-transplant lymphoproliferative disorder (PTLD) is a rare but frequently fatal complication of iatrogenic immunosuppression. PTLD encompasses a spectrum of B cell lymphoproliferations ranging from reactive plasmacytic hyperplasia to monomorphic B cell lymphoma. The tumours are almost always associated with Epstein-Barr Virus (EBV), and similar lymphoproliferative disorders also occur in other congenital and acquired immunodeficiency states. These malignancies reflect an imbalance in the normal control of EBV infection, although the virus is also linked to a subset of Hodgkin’s disease and T cell lymphomas in apparently immunocompetent individuals. Other EBV associated tumours occurring in particular areas of the world include Burkitt’s lymphoma in equatorial Africa and nasopharyngeal carcinoma in South East Asia. This review discusses the biology of EBV infection in the normal and immunocompromised host and the risk factors and pathogenesis of EBV associated PTLD.