Risk factors for early-onset and late-onset post-transplant lymphoproliferative disorder in kidney recipients in the United States.
Solid-organ transplant recipients have an elevated risk for some malignancies because of the requirement for immunosuppression [1]. In particular, non-Hodgkin's lymphoma (NHL) is common and comprises one end of a spectrum of post-transplant lymphoproliferative disorder (PTLD) ranging from benign hyperplasia to lymphoid malignancy [2]. PTLD risk is influenced by the type of organ transplanted, the age and Epstein-Barr virus (EBV) serostatus of the transplant recipient, and the intensity of immunosuppression [3-9]. PTLD incidence is high immediately after transplantation, decreases subsequently, and then rises again 4-5 years from transplantation [10,11]. This incidence pattern suggests the presence of separate early-onset and late-onset PTLD subtypes. Early-onset PTLDs tend to be EBV-positive and, when extranodal, are more likely than late-onset PTLDs to be localized to the transplanted organ [12,13]. Late-onset PTLD is less likely to be associated with EBV and, overall, is more likely than early-onset PTLD to be extranodal [13,14]. The Scientific Registry of Transplant Recipients (SRTR) includes data on a large number of solid-organ transplant recipients in the United States and information on malignancies diagnosed post-transplantation. We used these data to conduct a retrospective cohort study among kidney transplant recipients to examine differences in risk factors between early-onset PTLD and late-onset PTLD.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
Scott C
SC
Quinlan
Ruth M
RM
Pfeiffer
Lindsay M
LM
Morton
Eric A
EA
Engels
D000375:Aging; D015331:Cohort Studies; D019309:Epstein-Barr Virus Nuclear Antigens / Q000378:metabolism; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D015994:Incidence; D016030:Kidney Transplantation; D008232:Lymphoproliferative Disorders / Q000453:epidemiology* / Q000378:metabolism; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
D019309:Epstein-Barr Virus Nuclear Antigens
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