title: Risk of lymphoma subtypes after solid organ transplantation in the United States.
abstract: BACKGROUND
  Solid organ transplant recipients have high risk of lymphomas, including non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). A gap in our understanding of post-transplant lymphomas involves the spectrum and associated risks of their many histologic subtypes.
  
  
  METHODS
  We linked nationwide data on solid organ transplants from the US Scientific Registry of Transplant Recipients (1987-2008) to 14 state and regional cancer registries, yielding 791 281 person-years of follow-up for 19 distinct NHL subtypes and HL. We calculated standardised incidence ratios (SIRs) and used Poisson regression to compare SIRs by recipient age, transplanted organ, and time since transplantation.
  
  
  RESULTS
  The risk varied widely across subtypes, with strong elevations (SIRs 10-100) for hepatosplenic T-cell lymphoma, Burkitt's lymphoma, NK/T-cell lymphoma, diffuse large B-cell lymphoma, and anaplastic large-cell lymphoma (both systemic and primary cutaneous forms). Moderate elevations (SIRs 2-4) were observed for HL and lymphoplasmacytic, peripheral T-cell, and marginal zone lymphomas, but SIRs for indolent lymphoma subtypes were not elevated. Generally, SIRs were highest for younger recipients (<20 years) and those receiving organs other than kidneys.
  
  
  CONCLUSIONS
  Transplant recipients experience markedly elevated risk of a distinct spectrum of lymphoma subtypes. These findings support the aetiologic relevance of immunosuppression for certain subtypes and underscore the importance of detailed haematopathologic workup for transplant recipients with suspected lymphoma.
authors.affiliation: Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538-2334, USA. tina@cpic.org
authors.forename: C A
authors.initials: CA
authors.lastname: Clarke
authors.forename: L M
authors.initials: LM
authors.lastname: Morton
authors.forename: C
authors.initials: C
authors.lastname: Lynch
authors.forename: R M
authors.initials: RM
authors.lastname: Pfeiffer
authors.forename: E C
authors.initials: EC
authors.lastname: Hall
authors.forename: T M
authors.initials: TM
authors.lastname: Gibson
authors.forename: D D
authors.initials: DD
authors.lastname: Weisenburger
authors.forename: O
authors.initials: O
authors.lastname: Martínez-Maza
authors.forename: S K
authors.initials: SK
authors.lastname: Hussain
authors.forename: J
authors.initials: J
authors.lastname: Yang
authors.forename: E T
authors.initials: ET
authors.lastname: Chang
authors.forename: E A
authors.initials: EA
authors.lastname: Engels
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008223:Lymphoma / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult