title: Post-transplant lymphoproliferative disorder: no relationship to recombinant human growth hormone use in Australian and New Zealand pediatric kidney transplant recipients.
abstract: PTLD is a potentially life-limiting complication of pediatric transplantation. Previous registry-based studies in renal transplantation have suggested a link between rhGH use and PTLD. In this study, demographic and transplant data on those aged <18 yr and transplanted between 1991 and 2008 were collected from the ANZDATA Registry. Associations between gender, age at time of transplant, recipient CMV and EBV status, use of monoclonal antibody therapy, and use of rhGH were studied as potential predictors of PTLD. Among 650 transplants, there were 20 cases (3.1%) of PTLD, with half presenting within two yr post-transplant. Eight patients exposed to rhGH at any time developed PTLD, and this association was not statistically significant (RR = 1.5[0.6-3.4], p = 0.36). On multivariate analysis, there were no significant predictors for PTLD. In this study, previously identified potential risk factors were not identified as significant predictors for the development of PTLD. Although limited sample size may affect our ability to infer safety, this large retrospective cohort study does not suggest an increased risk of PTLD in pediatric kidney transplant recipients who received rhGH treatment.
authors.affiliation: Department of Endocrinology and Diabetes, Royal Children's Hospital, Brisbane, Qld, Australia.
authors.forename: Danielle K
authors.initials: DK
authors.lastname: Longmore
authors.forename: Louise S
authors.initials: LS
authors.lastname: Conwell
authors.forename: John R
authors.initials: JR
authors.lastname: Burke
authors.forename: Stephen P
authors.initials: SP
authors.lastname: McDonald
authors.forename: Steven J
authors.initials: SJ
authors.lastname: McTaggart
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003587:Cytomegalovirus; D005260:Female; D004854:Herpesvirus 4, Human; D019382:Human Growth Hormone / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D016030:Kidney Transplantation; D008232:Lymphoproliferative Disorders / Q000209:etiology*; D008297:Male; D015999:Multivariate Analysis; D009520:New Zealand; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012042:Registries; D051437:Renal Insufficiency / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D007074:Immunoglobulin G; D011994:Recombinant Proteins; D019382:Human Growth Hormone
keywords: Australian and New Zealand Dialysis and Transplant Registry; kidney transplantation; pediatrics; post-transplant lymphoproliferative disease; recombinant human growth hormone; renal transplantation