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Post-Transplant Lymphoproliferative Disorder (PTLD)

Developing efficient therapies is important for the improving of outcomes in transplant patients with a risk of post-transplant lymphoproliferative disorder (PTLD). Protheragen has a gifted group of researchers and scientists who have thorough knowledge in PTLD. They are committed in doing pioneering work to develop novel therapies for PTLD, intending to fill the gaps in available treatment options and progress precision medicine in the area.

Overview of Post-Transplant Lymphoproliferative Disorder (PTLD)

Post-transplant lymphoproliferative disorder (PTLD) encompasses a spectrum of lymphoproliferative disorders occurring in the context of immunosuppression in transplant recipients, from benign hyperplastic to malignant aggressive lymphomas. It is a major complication impacting 5-20% of transplant patients, with varying incidence based on transplanted organ type-intestinal and lung transplants demonstrate the highest rates.

Subtypes Characteristics Incidence
Early Lesions Reactive plasmacytic hyperplasia or infectious mononucleosis-like lesions, often EBV-driven. 20-30% of PTLD cases
Polymorphic PTLD Clonal but histologically heterogeneous lymphoid proliferations. 30-40% of PTLD cases
Monomorphic PTLD Overt lymphomas (mostly B-cell, e.g., diffuse large B-cell lymphoma). 40-50% of PTLD cases

Pathogenesis of Post-Transplant Lymphoproliferative Disorder (PTLD)

The primary driving factor of PTLD pathogenesis is the debilitating immunosuppression which, in the impairment of immune surveillance, enables unchecked growth of Epstein-Barr virus (EBV)-infected B cells. To take advantage of this situation, EBV expresses latent proteins (LMP1, LMP2A, and EBNAs) that activate survival and proliferation pathways, such as NF-κB, and mimic B cell receptor signaling. In the case of EBV-negative PTLD, factors such as genetic alterations with MYC translocations and TP53 mutations along with microenvironmental factors drive the lymphomagenesis.

Mechanisms underlying pathogenesis of post-transplant lymphoproliferative disorder (PTLD) and potential targets to mitigate disease development and progression.Fig.1 Mechanisms underlying pathogenesis of PTLD and potential targets to mitigate disease development and progression. (Asleh, Rabea, et al., 2022)

Therapy Development for Post-Transplant Lymphoproliferative Disorder (PTLD)

Therapy Mechanism of Action Targets NCT Number Research Phase
Polatuzumab Vedotin + Rituximab
  • Polatuzumab: Anti-CD79b antibody-drug conjugate.
  • Rituximab: Anti-CD20 mAb inducing ADCC/apoptosis.
CD79b/CD20 NCT06040320 Phase I/II
Obinutuzumab
  • Type II anti-CD20 mAb with enhanced ADCC and direct cell death induction.
CD20 NCT03086395 Phase II
Rituximab + Acalabrutinib
  • Rituximab: Anti-CD20 mAb.
  • Acalabrutinib: Irreversible BTK inhibitor blocking BCR signaling.
CD20/BTK NCT04337827 Phase II
Bortezomib + Rituximab
  • Bortezomib: Proteasome inhibitor inducing ER stress/apoptosis.
  • Rituximab: Anti-CD20 mAb.
Proteasome/CD20 NCT01058239 Phase I/II

Disclaimer: Protheragen focuses on providing preclinical research services. This table is for information exchange purposes only. This table is not a treatment plan recommendation. For guidance on treatment options, please visit a regular hospital.

Our Services

As a specialized research service provider, Protheragen is committed to accelerating breakthroughs in rare lymphoproliferative disorders (LPDs), particularly post-transplant lymphoproliferative disorder (PTLD). Our end-to-end solutions span diagnostic development, novel therapeutic discovery, precision disease modeling, and rigorous preclinical validation. By leveraging cutting-edge technologies and validated PTLD-specific models, we bridge the gap between research innovation and clinical translation, empowering partners to advance promising therapies from concept to commercialization.

Animal Model Development Services

  • Patient-Derived Xenograft (PDX) Model: NSG mice received pediatric patient-derived solid tumors and developed GvHD and PTLD between 46 and 283 days after transplantation.
  • Surgery + Chemical Induction Model: PTLD has been observed in miniature pigs that have received allogeneic hematopoietic cell transplantation using treatment regimens involving T-cell depletion and cyclosporine.

Protheragen is steadfastly dedicated to meticulously validating and optimizing therapies for post-transplant lymphoproliferative disorder (PTLD) through a thorough series of pharmacodynamics (PD), pharmacokinetics (PK) and toxicology studies. If you are interested in our services, please feel free to contact us for more details and quotation information of related services.

Reference

  • Asleh, Rabea, et al. "Post-transplant lymphoproliferative disorder following cardiac transplantation." Frontiers in Cardiovascular Medicine 9 (2022): 787975.