title: Treatment and outcomes of post-transplant lymphoproliferative disease: a single institution study.
abstract: Post-transplant lymphoproliferative disorders (PTLD) complicate up to 10% of solid organ transplants. This retrospective study was conducted to review the PTLD experience among 2,300 recipients of solid organ or allogeneic bone marrow transplants from a single institution. Twenty-seven cases of PTLD were identified, leading to an overall incidence of 1.2%. Polymorphic B cell hyperplasia/lymphoma was the most common type. The median time to development of PTLD was 8.4 months. Ten patients had localized (stage I or II) disease, and 12 patients presented with B symptoms. Nine patients each were treated with systemic chemotherapy or surgical resection as part of the initial therapy. After a median follow-up duration of 2.6 years, the median survival has not been reached. There were no late relapses of PTLD, and 17 patients remain alive. Age, sex, organ source, LDH, stage, presence of extranodal disease, or presentation with B symptoms did not influence overall survival when examined by Cox proportional hazard model. Thirteen patients retained their graft function throughout PTLD treatment. This study confirms the ability to treat a significant proportion of PTLD patients with chemotherapy or surgical resection (depending on presentation), without sacrificing graft function in those receiving chemotherapy.
authors.affiliation: Department of Medicine (Division of Hematology/Oncology; Greenebaum Cancer Center), University of Maryland School of Medicine, Baltimore, Maryland, USA. fbuadi@utcancer.com
authors.forename: Francis K
authors.initials: FK
authors.lastname: Buadi
authors.forename: Meyer R
authors.initials: MR
authors.lastname: Heyman
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Gocke
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Rapoport
authors.forename: Roger
authors.initials: R
authors.lastname: Hakimian
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Bartlett
authors.forename: Clarence
authors.initials: C
authors.lastname: Sarkodee-Adoo
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006084:Graft Rejection / Q000150:complications / Q000517:prevention & control; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D011878:Radiotherapy; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents