title: Is there a difference in post-transplant lymphoproliferative disorder in adults after solid organ and haematologic stem cell transplantation? Experience in 41 patients.
abstract: OBJECTIVE
  To determine if there is a difference in post-transplant lymphoproliferative disorder (PTLD) in adults after solid organ transplantation (SOT) and haematologic stem cell transplantation (HST).
  
  
  METHODS
  In this institutional review board-approved Health Insurance Portability and Accountability Act-compliant study, we reviewed clinical data and imaging at the time of diagnosis in 41 patients (26 SOT and 15 HST) (31 males and 10 females; mean age 51 years) with histopathology-confirmed PTLD seen at our institution from 2004 through 2013. Statistical analysis was performed to assess difference in distribution and survival between SOT and HST cohorts.
  
  
  RESULTS
  SOT: 17 lung/cardiac, 8 renal and 1 liver transplant recipients. HST: 13 leukaemia/lymphoma and 2 patients with aplastic anaemia. Median time to diagnosis: SOT 3.0 years; HST 6 months (Fisher's exact test; p = 0.0011). There was no statistically significant difference in distribution of PTLD after SOT and HST with nodes (15/26; 8/15), lung (10/26; 5/15) and bowel (6/26; 4/15) being the most common sites. Hepatic (3/26) and neurologic (2/26) involvement occurred in only SOT cohort while splenic PTLD (5/15) occurred more often in HST cohort. Death occurred earlier in HST (9/15; 2 weeks) than SOT cohort (12/26; 11 months) (Wilcoxon test; p = 0.0188).
  
  
  CONCLUSIONS
  PTLD did not differ significantly in distribution between SOT and HST cohorts. PTLD after HST occurred early and had shorter survival.
  
  
  CONCLUSIONS
  The most common sites of PTLD were the nodes, lung and bowel. Distribution of PTLD does not differ significantly between patients with SOT and HST. PTLD after HST occurs early and has poor survival compared with PTLD after SOT.
authors.affiliation: 1 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Tai
authors.affiliation: 1 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|2 Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Tirumani
authors.affiliation: 2 Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Tirumani
authors.affiliation: 1 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|2 Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Shinagare
authors.affiliation: 3 Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Hornick
authors.affiliation: 1 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|2 Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: N H
authors.initials: NH
authors.lastname: Ramaiya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003586:Cytomegalovirus Infections / Q000175:diagnosis; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis; D005260:Female; D006402:Hematologic Diseases / Q000473:pathology / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult