Predictors of outcome in post-transplant lymphoproliferative disorder: an evaluation of tumor infiltrating lymphocytes in the context of clinical factors.
We hypothesized that the number of tumor infiltrating cytotoxic T-cells (CTCs) and regulatory T-cells (Tregs), shown to have prognostic value in other lymphoproliferative disorders, could predict survival in post-transplant lymphoproliferative disorder (PTLD). Sixty-two patients were diagnosed with PTLD between 1987 and 2007, with 44 cases representing monomorphic B-cell PTLDs with diffuse aggressive morphologic features. Of these 44 cases, 31 had sufficient tissue for further study. On univariate analysis, high tumor infiltrating CD3(+) T-cell (> or =550/10 hpf) and TIA-1(+) CTC (> or =300/10 hpf) counts were associated with favorable overall survival (OS), PTLD-specific survival (PTLD-SS), and progression-free survival (PFS) while Treg counts were not predictive of outcome. However, on multivariate analysis, clinical factors were the most powerful predictor of PTLD outcome (performance status and CHOP as first line therapy for OS; performance status and number of extranodal sites for both PTLD-SS and PFS).
Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
Bill G
BG
Richendollar
Raymond E
RE
Tsao
Paul
P
Elson
Tao
T
Jin
Roxanne
R
Steinle
Brad
B
Pohlman
Eric D
ED
Hsi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017252:CD3 Complex / Q000378:metabolism; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology*; D008232:Lymphoproliferative Disorders / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods; D013601:T-Lymphocytes / Q000378:metabolism / Q000473:pathology*; D016378:Tissue Transplantation; D016896:Treatment Outcome; D055815:Young Adult
D017252:CD3 Complex