Belatacept (Nulojix) is a selective T-cell co-stimulation blocker that is used to prevent rejection in renal transplant patients. It is associated with a number of potentially serious complications, one of which is a posttransplant lymphoproliferative disorder (PTLD).
The posttransplant lymphoproliferative disorder in patients treated with belatacept most often involves the central nervous system (CNS).
Risk factors for PTLD in a patient treated with belatacept:
(1) seronegativity for Epstein-Barr virus (EBV)
(2) use of a high dose of belatacept
(3) cytomegalovirus (CMV) infection
(4) T-cell depleting therapy for acute rejection
(5) high total level of immunosuppression
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