Post-transplant lymphoproliferative diseases in Asian solid organ transplant recipients: late onset and favorable response to treatment.
Nineteen consecutive patients with post-transplant lymphoproliferative disorders (PTLD) in an Asian population were reviewed. The histopathologic diagnoses were monomorphic (CD20-positive diffuse large B-cell lymphoma, n = 14); plasmacytic (n = 1); Burkitt-like (n = 1); natural killer cell lymphoma (n = 1); lymphomatoid papulosis (n = 1); and classical Hodgkin lymphoma (n = 1). Early-onset (<one yr post-transplantation) PTLD constituted only 10% of cases, and all were Epstein-Barr virus (EBV) positive. EBV-negative cases (n = 6) developed at a median of 92 (19-170) months, whereas EBV-positive cases occurred later at 128 (7-230) months. With reduction of immunosuppression followed by local therapy, treatment with the anti-CD20 antibody rituximab with or without combination chemotherapy, complete remission was achieved in 17/19 (90%) of cases. Lactate dehydrogenase level, stage, extranodal involvement, EBV status, and International Prognostic Index had no impact on treatment outcome. EBV-positive PTLD occurred much later in Asian patients. Treatment results of PTLD were favorable.
Department of Medicine, Queen Mary Hospital             Department of Pathology, Queen Mary Hospital, Hong Kong, China.
Thomas S Y
TS
Chan
Yu-Yan
YY
Hwang
Harinder
H
Gill
Wing-Yan
WY
Au
Anskar Y H
AY
Leung
Eric
E
Tse
Chor-Sang
CS
Chim
Florence
F
Loong
Yok-Lam
YL
Kwong
D000328:Adult; D000368:Aged; D002681:China; D004359:Drug Therapy, Combination; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy / Q000401:mortality / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000472:pathogenicity; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000401:mortality / Q000601:surgery; D008232:Lymphoproliferative Disorders / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects* / Q000401:mortality; D011183:Postoperative Complications; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate
D007166:Immunosuppressive Agents