title: Post-transplant lymphoproliferative disease after allogeneic hematopoietic stem cell transplantation: a single-center experience.
abstract: BACKGROUND
  Post-transplant lymphoproliferative disease (PTLD) is a rare and serious complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) or solid organ transplantation.
  
  
  METHODS
  We conducted a retrospective analysis of the occurrence of post-transplant lymphoproliferative disease in allo-HSCT recipients over 12 years in a single center in China. A total of 343 patients received allo-HSCT. The conditioning therapy consisted of a busulfan/cyclophosphamide-based regimen, a fludarabine/cyclophosphamide-based regimen, or total-body irradiation and cyclophosphamide. In transplantations from unrelated donors and haplo-identical donors, patients also received antithymocyte globulin (ATG) or thymoglobulin as part of the conditioning.
  
  
  RESULTS
  Five of the 343 patients (1.46%) were diagnosed with PTLD and all 5 were given ATG as part of conditioning. Among these 5 patients, 4 had lymphoid neoplasm before transplantation. EBV-positivity was confirmed in 4 patients. All 5 PTLD patients received reduction of immunosuppression (RI) as fundamental therapy. At follow-up on April 1, 2013, 1 patient had survived for 2 years and 1 had survived for 9 years. The correlation of PTLD with ATG and underlying diseases were examined by statistical analysis using the chi-squared test or Fisher's exact test (P=0.011 and 0.025, respectively).
  
  
  CONCLUSIONS
  Although only 1.46% of patients progressed to PTLD associated with ATG and underlying diseases, the mortality was still high. Moreover, RI can be an effective therapy for PTLD patients, but other approaches should be further explored.
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Lan
authors.initials: L
authors.lastname: Luo
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Bo
authors.initials: B
authors.lastname: Cai
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Honghua
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Wenrong
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Yu
authors.initials: Y
authors.lastname: Jing
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Haiyan
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Jian
authors.initials: J
authors.lastname: Bo
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Quanshun
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Han
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Li
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Hematology, BMT Center, Chinese PLA General Hospital, Beijing, China (mainland).
authors.forename: Chunji
authors.initials: C
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D002066:Busulfan / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008232:Lymphoproliferative Disorders / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D019653:Myeloablative Agonists; D003520:Cyclophosphamide; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine