Clinical characteristics and outcomes of posttransplant lymphoproliferative disorders following allogeneic hematopoietic stem cell transplantation in Korea.
Between 1995 and 2003, seven cases of posttransplant lymphoproliferative disorder (PTLD) were identified among 1,116 patients who received allogeneic hematopoietic stem cell transplantations (HSCT) at Catholic HSCT Center (overall incidence 0.6%). Five (71.4%) patients had episodes of acute graft-versus-host-disease (GVHD) and were treated with steroids. Cervical lymphadenopathy was observed in most cases (71.4%), but clinical symptoms varied depending on the involved sites. Pathologic findings varied: 1 case of plasmacytic hyperplasia, 3 of polymorphic PTLD, 2 of diffuse large B-cell lymphoma, 1 of large T-cell lymphoma, which proved to be associated with Epstein-Barr virus (EBV). The proportion of EBV-negative PTLD was 33.3%. Five patients demonstrated a good response to treatment (treatment response rate 71.4%). The overall mortality was 42.8%, and one death was directly attributable to PTLD. The incidence of PTLD is expected to increase, based on the rising use of grafts from alternative donors and recent clinical features of PTLD manifested by a disseminated and fulminant nature. It is necessary to have a high level of suspicion when monitoring patients and readily adopt prompt and effective cellular immunotherapy for PTLD.
Park
Sun Hee
SH
Department of Internal Medicine, The Catholic Hematopoietic Stem Cell Transplantation Center, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Choi
Su Mi
SM
Lee
Dong Gun
DG
Choi
Jung Hyun
JH
Yoo
Jin Hong
JH
Kim
Hee Je
HJ
Kim
Dong Wook
DW
Lee
Jong Wook
JW
Min
Woo Sung
WS
Shin
Wan Shik
WS
Kim
Chun Choo
CC
D000293:Adolescent; D000328:Adult; D020031:Epstein-Barr Virus Infections / Q000209:etiology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007723:Korea; D016393:Lymphoma, B-Cell / Q000209:etiology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000209:etiology; D016399:Lymphoma, T-Cell / Q000209:etiology; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous