title: Risk factors and prognosis in T-cell posttransplantation lymphoproliferative diseases:  reevaluation of 163 cases.
abstract: BACKGROUND
  Posttransplantation lymphoproliferative diseases (PTLD) are mainly Epstein-Barr virus (EBV)-associated disorders of B-cell origin. Due to the rarity of monomorphic T-cell PTLD (T-PTLD), knowledge about pathogenesis, risk factors, therapy, and prognosis relies predominantly on case reports and small series. Therefore, we aimed to provide an overview and a retrospective analysis of this rare PTLD subtype.
  
  
  METHODS
  We analyzed all available articles on T-PTLD in the PubMed database as well as in our own databases (Institute of Pathology/Department of Paediatric Haematology and Oncology, Hannover Medical School) from 1988 to 2010. Reevaluated parameters were gender, age, transplanted organ, immunosuppressant regimen, time between transplantation and T-PTLD manifestation, T-PTLD subtype, virus positivity, localization, therapy, and follow-up.
  
  
  RESULTS
  A total of 163 cases were evaluated. We found that hematopoietic stem cell transplantation was associated with early-onset T-PTLD, whereas late onset occurred after immunosuppression with steroids and azathioprine without administration of calcineurin inhibitors. The major independent favorable prognostic factors were T-PTLD of the large granular lymphocytic leukemia subtype, young age, and a combination of radiotherapy/radiochemotherapy and reduced immunosuppression, whereas the hepatosplenic T-cell lymphoma subtype and cases with involvement of bone marrow, the central nervous system, or graft had an adverse prognosis.
  
  
  CONCLUSIONS
  T-PTLD is a heterogeneous group of different aberrant T-cell proliferations and represents a significant complication following transplantation, showing a uniformly poor prognosis.
authors.affiliation: Institute of Pathology, Hannover Medical School, Hannover, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Tiede
authors.forename: Britta
authors.initials: B
authors.lastname: Maecker-Kolhoff
authors.forename: Christoph
authors.initials: C
authors.lastname: Klein
authors.forename: Hans
authors.initials: H
authors.lastname: Kreipe
authors.forename: Kais
authors.initials: K
authors.lastname: Hussein
mesh_terms: D000328:Adult; D049109:Cell Proliferation; D015897:Comorbidity; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013601:T-Lymphocytes / Q000473:pathology*