Post-transplant lymphoproliferative disorders after solid organ and hematopoietic stem cell transplantation

Abstract

Post-transplant lymphoproliferative disorders (PTLD) are a rare complication after both solid organ (SOT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this single center retrospective study, we compared clinical, biological, and histological features, and outcomes of PTLD after both types of transplant. We identified 82 PTLD (61 after SOT and 21 after allo-HSCT). The presence of B symptoms, Waldeyer ring, spleen, central nervous system, and liver involvement, and advanced Ann-Arbor stage were more frequent in allo-HSCT recipients. PTLD had an earlier onset in allo-HSCT than in SOT cohort (4 vs. 64 months, p < .0001). PTLD was EBV-positive in 100% of allo-HSCT, in contrast to 47% of SOT (p = .0002). Four years after PTLD diagnosis, median overall survival was 32% (95% CI, 22-48) and 10% (95% CI, 2-49) in SOT and allo-HSCT recipients, respectively (p = .002). In conclusion, the clinical presentation and the outcome of PTLD varies greatly depending on the type of transplant.

Low rates of acute and chronic GVHD with ATG and PTCy in matched and mismatched unrelated donor peripheral blood stem cell transplants

“…33 PTLD in the setting of allo-SCT is strongly correlated with EBV DNAemia. 34 Pre-emptive treatment strategies with rituximab have been used to improve survival in patients at high risk for developing PTLD such as those receiving ATG or alemtuzumab in the conditioning regimen. 35 Although the incidence of EBV reactivation and PTLD in our patients was high, all patients responded well to rituximab monotherapy.…”

Diagnosis of Pleural Lymphoma in a Kidney Transplant Patient by Medical Pleuroscopy with Cryoprobe Biopsies

“…PTLD is a recognized complication of allogeneic and hematopoietic stem cell transplantation as well as solid organ transplantation. PTLD is associated with Epstein-Barr virus (EBV), due to reactivation or primary infection [8]. In a single center study in Korea, of their 3305 kidney transplant cases, only 24 cases were diagnosed with PTLD (0.72%), 9 within 2 years of transplantation.…”

Lymphoma of the lip after kidney transplantation: a case report

“…The first cases were reported in 1968 by DOAK and al. for kidney recipient [3]. This is a well-known complication for transplant recipient due to the immunosuppressive treatment used to prevent graft rejecting.…”

“…The other risk factors of PTLD are EBV infections, age, transplant type and immunosuppressive therapy provided. The mean age correlated with diagnosis is about 46/48 years in many studies [3,7,8,9], but the risk is linked to the age at the moment of the transplantation: the younger the recipient is, the higher the risk gets. For the transplant type, PTLD prevails most often (20% of patients) for bowel recipients; less often for liver and kidney recipients 2.4-8% vs 1-10%, and even less for bone marrow recipients (1%) [10].…”

“…Lymphomas are more likely to develop in immunosuppressed patients like transplant recipients forming the post-transplant lymphoproliferative disorders (PTLD). These are a well-recognized complication of solid organ transplantation and need to be found out during the tracking of patients in order to be cured prematurely [3]. Lesions affect commonly the vestibule, gingival, or posterior hard palate and develop slowly as non-tender swellings, mimicking a dental abscess of endodontic or periodontal origin [4].…”