Lymphoproliferative disorders after organ transplantation: a report of 24 cases observed in a single center.

Leblond, Véronique; Sutton, Laurent; Dorent, Richard; Davi, Frédéric; Bitker, Marc‐Olivier; Gabarre, Jean; Charlotte, Frédéric; Ghoussoub, Jean–Jacques; Fourcade, C.; Fischer, Alain

doi:10.1200/jco.1995.13.4.961

Cited by 258 publications

(162 citation statements)

References 27 publications

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“…In heart recipients, mortality from lymphoma was even higher -50% in the first year -and no improvement in survival was noted between patients transplanted recently or earlier ( Figure 8B). Contrary to claims in the literature (22,23,28,29) the time to development of lymphoma did not prognosticate survival in kidney or heart recipients. Five-year survival was 41.4% (n = 125) and 37.0% (n = 575) for kidney recipients whose tumors developed in <90 days or >365 days, respectively (p = NS); the corresponding 5-year survival rates in heart recipients were 33.3% (n = 42) and 30.0% (n = 398) (p = NS).…”

Section: Patient Survivalcontrasting

confidence: 99%

“…Several reports have suggested differences between the clinical and biological characteristics of lymphomas that develop early or late after transplantation. Late-appearing lymphomas frequently lack EBV genome sequences, were reported to respond poorly to reduction or discontinuation of immunosuppression, and generally are believed to have a poorer outcome (22,23,28,29). In contrast to these reports, our data suggest that lymphomas have a poor outcome regardless of time of appearance after transplantation.…”

Section: Lymphomas After Solid Organ Transplantationcontrasting

confidence: 87%

“…In contrast to these reports, our data suggest that lymphomas have a poor outcome regardless of time of appearance after transplantation. Reduction of immunosuppression to reestablish host defense mechanisms has been recommended as the first step in the treatment of post-transplant lymphoma; although this approach does lead to complete and durable resolution of some lymphomas, the results are variable and graft rejection is a serious risk (20,28). Our data indicate that lymphoma posttransplantation continues to be a life-threatening condition, despite recent therapeutic advancements.…”

Section: Lymphomas After Solid Organ Transplantationmentioning

confidence: 81%

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Lymphomas After Solid Organ Transplantation: A Collaborative Transplant Study Report

Opelz

Döhler

2004

American Journal of Transplantation

977

787

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We used the Collaborative Transplant Study database to analyze the incidence, risk, and impact of malignant lymphomas in approximately 200 000 organ transplant recipients. Over a 10-year period, the risk in renal transplant recipients was 11.8-fold higher than that in a matched nontransplanted population (p < < 0.0001). The majority of lymphomas were diagnosed after the first post-transplant year. Heart-lung transplants showed the highest relative risk (RR 239.5) among different types of organ transplants. In kidney recipients, immunosuppression with cyclosporine did not confer added risk compared with azathioprine/steroid treatment, whereas treatment with FK506 increased the risk approximately twofold. Induction therapy with OKT3 or ATG, but not with anti-IL2 receptor antibodies, increased the risk of lymphoma during the first year. Antirejection therapy with OKT3 or ATG also increased the risk. First-year mortality in renal and heart transplant patients with lymphoma was approximately 40% and 50%, respectively, and showed no improvement in recent years. A pattern of preferential localization to the vicinity of the transplant was noted, and the prognosis of the patient was related to localization. This study highlights the continuing risk for lymphoma with time post-transplantation, the contribution of immunosuppression to increased risk, and continuing poor outcomes in patients with post-transplant lymphoma.

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Section: Patient Survivalcontrasting

confidence: 99%

Section: Lymphomas After Solid Organ Transplantationcontrasting

confidence: 87%

Section: Lymphomas After Solid Organ Transplantationmentioning

confidence: 81%

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Lymphomas After Solid Organ Transplantation: A Collaborative Transplant Study Report

Opelz

Döhler

2004

American Journal of Transplantation

977

787

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“…Post-transplant lymphoproliferative disorders have emerged as a major problem associated with solid organ and allogeneic BMT, with an incidence varying from less than 2 to 10% in various reports [1,2]. The variation in reported incidence rates is partly because of differences in the types of organ transplanted, immune suppressive therapy [9], period of observation [10], and patient demographics [2].…”

Section: Discussionmentioning

confidence: 99%

“…Lymphoproliferative diseases are now clearly recognized as a complication of solid organ as well as blood and marrow transplantation (BMT), with a reported incidence ranging from 2 to 10% [1,2]. Registry-based reports, although very informative as far as incidence rates and predisposing factors, do not usually provide details of treatment and outcomes.…”

Section: Introductionmentioning

confidence: 99%

Treatment and outcomes of post‐transplant lymphoproliferative disease: A single institution study

et al. 2006

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Post-transplant lymphoproliferative disorders (PTLD) complicate up to 10% of solid organ transplants. This retrospective study was conducted to review the PTLD experience among 2,300 recipients of solid organ or allogeneic bone marrow transplants from a single institution. Twenty-seven cases of PTLD were identified, leading to an overall incidence of 1.2%. Polymorphic B cell hyperplasia/lymphoma was the most common type. The median time to development of PTLD was 8.4 months. Ten patients had localized (stage I or II) disease, and 12 patients presented with B symptoms. Nine patients each were treated with systemic chemotherapy or surgical resection as part of the initial therapy. After a median follow-up duration of 2.6 years, the median survival has not been reached. There were no late relapses of PTLD, and 17 patients remain alive. Age, sex, organ source, LDH, stage, presence of extranodal disease, or presentation with B symptoms did not influence overall survival when examined by Cox proportional hazard model. Thirteen patients retained their graft function throughout PTLD treatment. This study confirms the ability to treat a significant proportion of PTLD patients with chemotherapy or surgical resection (depending on presentation), without sacrificing graft function in those receiving chemotherapy. Am. J. Hematol. 82:208-214, 2007. V V C 2006 Wiley-Liss, Inc.

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Clinical and Pathological Features of Posttransplantation Lymphoproliferative Disorders Presenting With Skin Involvement in 4 Patients

Beynet¹,

Wee²,

Horwitz³

et al. 2004

Arch Dermatol

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Lymphoproliferative disorders after organ transplantation: a report of 24 cases observed in a single center.

Abstract: Anti-B-cell monoclonal antibody therapy seems to be effective in PTLD, even in monoclonal B-cell forms, but other approaches will be necessary to improve survival further.

Cited by 258 publications

References 27 publications

Lymphomas After Solid Organ Transplantation: A Collaborative Transplant Study Report

Lymphomas After Solid Organ Transplantation: A Collaborative Transplant Study Report

Treatment and outcomes of post‐transplant lymphoproliferative disease: A single institution study

Clinical and Pathological Features of Posttransplantation Lymphoproliferative Disorders Presenting With Skin Involvement in 4 Patients

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