Differences between early and late posttransplant lymphoproliferative disorders in solid organ transplant patients: are they two different diseases?
BACKGROUND
The objective of the authors' study was to characterize the clinical and pathologic differences between patients who develop posttransplant lymphoproliferative disorders (PTLD) early or late after transplantation and to assess the overall survival in these two groups.


METHODS
One hundred seven adult solid organ transplant patients were identified at the Mayo Clinic between December 1970 and May 2003.


RESULTS
Forty-nine patients developed PTLD within the first year (early PTLD, 1-11.8 months) and 58 patients developed PTLD after 1 year (late PTLD, 14 months-17 years). Patients with early PTLD more commonly had the following characteristics: positive Epstein-Barr virus (EBV) in situ hybridization status (P < 0.0001), CD20-positive status (P = 0.002), and involvement of the grafted organ (P = 0.02). Overall survival did not differ between the two groups (P = 0.25). PTLD may occur in two different settings with different characteristics.


CONCLUSIONS
Early PTLD is more commonly EBV in situ hybridization-positive and CD20-positive, and more commonly involves the grafted organ.
Ghobrial
Irene M
IM
Division of Hematology, Department of Internal Medicine, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA.
Habermann
Thomas M
TM
Macon
William R
WR
Ristow
Kay M
KM
Larson
Timothy S
TS
Walker
Randall C
RC
Ansell
Stephen M
SM
Gores
Gregory J
GJ
Stegall
Mark D
MD
McGregor
Christopher G
CG
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000276:immunology; D016019:Survival Analysis; D013997:Time Factors; D014181:Transplantation Immunology