T-cell and NK-cell posttransplantation lymphoproliferative disorders.
Posttransplantation lymphoproliferative disorders (PTLDs) of T-cell or natural killer (NK)-cell origin are an uncommon heterogeneous group of lymphoid proliferations that fulfill the criteria for one of the T- or NK-cell lymphomas/leukemias. This report summarizes 130 T/NK-cell PTLDs reported in the literature or presented at the Society for Hematopathology/European Association for Haematopathology Workshop on T/NK-cell malignancies. The T/NK-cell PTLDs occur at a median of 66 months following transplantation and are usually extranodal. The most common types reported are peripheral T-cell lymphoma, unspecified, and hepatosplenic T-cell lymphoma. Approximately one third are Epstein-Barr virus (EBV)+. The median survival is 6 months. EBV+ cases have a significantly longer survival than EBV- cases, even when indolent T-cell large granular lymphocytic leukemias are included among the EBV- cases. Many T/NK-cell PTLDs have been treated with chemotherapy, often together with decreased immunosuppression, but there are infrequent patients who have done well without chemotherapy or radiation.
Swerdlow
Steven H
SH
Department of Pathology, Division of Hematopathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
D020031:Epstein-Barr Virus Infections / Q000150:complications; D006801:Humans; D007694:Killer Cells, Natural / Q000473:pathology*; D016411:Lymphoma, T-Cell, Peripheral / Q000209:etiology / Q000401:mortality / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D016377:Organ Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications; D015996:Survival Rate; D013601:T-Lymphocytes / Q000473:pathology*