title: CD20 expression predicts survival in paediatric post-transplant lymphoproliferative disease (PTLD) following solid organ transplantation.
abstract: The prognostic role of CD20 expression and Epstein-Barr virus (EBV) positivity in post-transplant lymphoproliferative disease (PTLD) after solid organ transplantation (SOT) in paediatric patients is poorly understood. We retrospectively examined the relationship of CD20 and EBV with the time interval from SOT to PTLD diagnosis, and PTLD-related event-free (EFS) and overall survival (OS) in 45 consecutive PTLD patients (≤25 years) following SOT. These 45 paediatric SOT patients (28 heart, 11 liver, six kidney) were diagnosed with PTLD 45 months (mean; SD 43; range 4-153; median 24·5) after SOT, with PTLD diagnosis at 118 months (mean) (SD 77; range 14-287) of age. Of 40 evaluable tumours (11 monomorphic, 19 polymorphic, five early lesions, five rare subtypes), 32 (80%) had detectable EBV and 28 (70%) were classified as CD20(+) . Patients whose PTLD expressed CD20 or EBV had shorter intervals between SOT and PTLD onset (28 vs. 64 or 77 months for CD20 and EBV respectively) (P < 0·02), even after adjusting for age at SOT. Patients with CD20(+) tumours had higher 5-year PTLD-related EFS (83·7% vs. 28·6%, P < 0·001) and OS (95·8% vs. 56·3%, P = 0·01). EBV expression was unrelated to PTLD-related EFS or OS. CD20 expression is associated with timing of development of PTLD and predicts survival in PTLD diagnosed following paediatric SOT.
authors.affiliation: Departments of Pediatrics, Columbia University, New York-Presbyterian Morgan Stanley Children's Hospital New York, NY, USA. mao5@columbia.edu
authors.forename: Manuela A
authors.initials: MA
authors.lastname: Orjuela
authors.forename: Bachir
authors.initials: B
authors.lastname: Alobeid
authors.forename: Xinhua
authors.initials: X
authors.lastname: Liu
authors.forename: Aisha L
authors.initials: AL
authors.lastname: Siebert
authors.forename: Emily R
authors.initials: ER
authors.lastname: Kott
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Addonizio
authors.forename: Erin
authors.initials: E
authors.lastname: Morris
authors.forename: James H
authors.initials: JH
authors.lastname: Garvin
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Lobritto
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Cairo
mesh_terms: D000293:Adolescent; D018951:Antigens, CD20 / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000276:immunology* / Q000821:virology; D008297:Male; D016377:Organ Transplantation / Q000009:adverse effects*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D018951:Antigens, CD20; D015415:Biomarkers