Posttransplant lymphoproliferative disorders in kidney transplant recipients: an Iranian multicenter experience.
BACKGROUND
Limited data with adequate sample size exist on the development of posttransplant lymphoproliferative disorder (PTLD) in living donor kidney recipients. We conducted a retrospective cohort study on the data of 10 transplant centers to identify the incidence of PTLD in Iran.


METHODS
Data of 9917 kidney transplant recipients who received their kidneys between 1984 and 2008 were reviewed. Fifty-one recipients (0.5%) who developed PTLD were evaluated with a median follow-up of 47.5 months (range, 1 to 211) months.


RESULTS
Patients with PTLD represented 24% of all posttransplant malignancies (51 out of 211 cases). There was no relationship between PTLD and sex (P = .20). There were no statistically significance differences considering the age at transplantation between patients with and without PTLD. The late-onset PTLD (70.6%) occurred more frequently compared to the early form. There was no signification relationship between early-onset and late-onset groups in terms of clinical course and outcome. In patients who received azathioprine, PTLD was more frequent when compared to those who received mycophenolate mofetil (P < .001). The lymph nodes were the predominantly involved site (35.3%), followed by the gastrointestinal tract, brain, kidney allograft, lung, ovary, vertebrae, and palatine. Age at diagnosis and the time from transplantation to diagnosis were comparable for various involvement sites of PTLDs. The overall mortality in this series of patients was 51.0%.


CONCLUSIONS
Posttransplant lymphoproliferative disorder is a rare but devastating complication and long-term prognosis can be improved with early recognition and appropriate therapy.
Nephrology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. einollahi@bmsu.ac.ir
Behzad
B
Einollahi
Mahboob
M
Lessan-Pezeshki
Mohammad Hossein
MH
Nourbala
Nasser
N
Simforoosh
Vahid
V
Pourfarziani
Eghlim
E
Nemati
Mohsen
M
Nafar
Abbas
A
Basiri
Fatemeh
F
Pour-Reza-Gholi
Ahmad
A
Firoozan
Mohammad Hassan
MH
Ghadiani
Khadijeh
K
Makhdoomi
Ali
A
Ghafari
Pedram
P
Ahmadpour
Farshid
F
Oliaei
Mohammad Reza
MR
Ardalan
Atieh
A
Makhlough
Hamid Reza
HR
Samimagham
Jalal
J
Azmandian
Efat
E
Razeghi
Heshmatollah
H
Shahbazian
D000293:Adolescent; D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000009:adverse effects*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007492:Iran; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000150:complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D001379:Azathioprine