Incidence and clinical characteristics of posttransplant lymphoproliferative disorders: report from a single center.
In the period 1973-1998, among 2139 allograft recipients treated with standard immunosuppression, posttransplant lymphoproliferative disorders (PTLD) developed in 19 patients (0.9%): one plasmacytic hyperplasia, two polymorphic PTLD, one myeloma, and 15 lymphomas. PTLD developed 1 year after transplantation (tx) in 14 patients. Five patients were diagnosed at autopsy, 2 were lost to follow up, 3 died before therapy could be instituted, and 1 patient has just started chemotherapy. Of the 8 evaluable patients, 2 received acyclovir and are alive in complete remission (CR) and 6 received chemotherapy +/- surgery. Of these 6, 4 died of lymphoma and/or infection, 1 died of unrelated causes in CR, and 1 is alive in CR. PTLD is a severe complication of tx, usually running an aggressive course which may preclude prompt diagnosis and treatment. Nevertheless, therapy is feasible and must be tailored on the histologic subtype. Seventy-four percent of patients were diagnosed with late-onset PTLD stressing the need for long-term follow up.
Muti
G
G
Department of Hematology, Niguarda Ca' Granda Hospital, Milan, Italy. SP00052@CHERING-PLOUGH.IT
De Gasperi
A
A
Cantoni
S
S
Oreste
P
P
Gini
G
G
Civati
G
G
Busnach
G
G
Brando
B
B
Frigerio
M
M
Mangiavacchi
M
M
Alberti
A
A
Decarus
L
L
Rondinara
G
G
De Giuli
E
E
Morra
E
E
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D004359:Drug Therapy, Combination; D006801:Humans; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007558:Italy; D016030:Kidney Transplantation; D008232:Lymphoproliferative Disorders / Q000145:classification / Q000453:epidemiology* / Q000276:immunology; D008875:Middle Aged; D016377:Organ Transplantation; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous
D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D000212:Acyclovir