{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T13:49:48Z","timestamp":1781617788618,"version":"3.54.5"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Monomorphic post\u2010transplant lymphoproliferative disorder (mPTLD) is a major cause of morbidity\/mortality following solid organ transplant (SOT), with infection, mPTLD progression and organ rejection presenting equal risks. Balancing these risks is challenging, and the intensity of therapy required by individual patients is not defined. Although an increasing body of evidence supports the use of a stepwise escalation of therapy through reduction in immunosuppression (RIS) to rituximab monotherapy and low\u2010dose chemo\u2010immunotherapy, many centres still use B\u2010cell non\u2010Hodgkin lymphoma (B\u2010NHL) protocols, especially when managing Burkitt\/Burkitt\u2010like (BL) PTLD. This study sought to define outcomes for children managed in the UK or Spanish centres using low\u2010intensity first\u2010line treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>Retrospective data were anonymously collected on patients younger than 18\u00a0years of age, with post\u2010SOT mPTLD diagnosed between 2000 and 2020. Only patients given low\u2010intensity treatment at initial diagnosis were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010six patients were identified. Age range was 0.9\u201318\u00a0years (median 10.7). Most (62.5%) had early\u2010onset PTLD. Haematopathological analysis showed 75% were diffuse large B\u2010cell like, 14.3% were BL and nine of 33 (27%) harboured a\n                      <jats:italic>MYC<\/jats:italic>\n                      \u2010rearrangement. Stage III\u2013IV disease was present in 78.6%. All but one had RIS, 26 received rituximab monotherapy and 24 low\u2010dose chemo\u2010immunotherapy, mostly R\u2010COP. Intensified B\u2010NHL chemotherapy was required in 10\/56 (17.9%). There were a total of 13 deaths in this cohort, three related to PTLD progression. The 1\u2010year overall survival (OS), event\u2010free survival (EFS) and progression\u2010free survival (PFS) were 92.8%, 78.6% and 80.2%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>R\u2010COP provides an effective low\u2010dose chemotherapy option. Escalation to more intensive therapies in the minority of inadequately controlled patients is an effective strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.31053","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T01:54:51Z","timestamp":1715910891000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Management of paediatric monomorphic post\u2010transplant lymphoproliferative disorders with low\u2010intensity treatment: A multicentre international experience"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7740-0614","authenticated-orcid":false,"given":"Pilar","family":"Guerra\u2010Garc\u00eda","sequence":"first","affiliation":[{"name":"Paediatric Haematology and Oncology Department University Hospital <i>La Paz<\/i>  Madrid Spain"},{"name":"Translational Research in Paediatric Oncology Haematopoietic Transplantation and Cell Therapy University Hospital <i>La Paz<\/i> Institute for Health Research \u2010 IdiPAZ  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Bomken","sequence":"additional","affiliation":[{"name":"The Great North Children's Hospital Newcastle upon Tyne Hospitals NHS Foundation Trust  Newcastle upon Tyne UK"},{"name":"Wolfson Childhood Cancer Research Centre Translational and Clinical Research Institute Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Ling","sequence":"additional","affiliation":[{"name":"MRC Weatherall Institute of Molecular Medicine University of Oxford John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arina","family":"Lazareva","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplantation Great Ormond Street Hospital for Children  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9026-1583","authenticated-orcid":false,"given":"Girish","family":"Gupte","sequence":"additional","affiliation":[{"name":"Liver Unit Birmingham Women's and Children's Hospital NHS Foundation Trust  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Persis","family":"Amrolia","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplantation Great Ormond Street Hospital for Children  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Paediatric Oncology University Hospital <i>La Fe<\/i>  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Diez\u2010Sebasti\u00e1n","sequence":"additional","affiliation":[{"name":"Epidemiology and Statistics University Hospital <i>La Paz<\/i>  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7107-618X","authenticated-orcid":false,"given":"Mary M.","family":"Taj","sequence":"additional","affiliation":[{"name":"The Royal Marsden Hospital, Sutton  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968\u20106053(97)80005\u20101"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200003000-00006"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34600"},{"issue":"1","key":"e_1_2_9_5_1","first-page":"8","article-title":"Posttransplant lymphoproliferative disorders: summary of Society for Hemopathology Workshop","volume":"14","author":"Harris NL","year":"1997","journal-title":"Semin Diagn 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