Post-Transplant Lymphoproliferative Disorders Occurring after Organ Transplantation: A Single Center Experience
SO Yoon, ES Yu, YM Cho, SK Lee, CW Suh, DJ Han, JW Lee, JR Huh. University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
Background: Posttransplant lymphoproliferative disorders (PTLD) is a rare complication of organ transplantation with poor outcomes. Consensual prognostic criteria has not been established to date. Present study evaluated PTLD cases to analyze the clinicopathological characteristics in the aspect of prognosis.
Design: Forty four adult or pediatric patients who were diagnosed with PTLDs after solid organ, or bone marrow transplantation at the Seoul Asan Medical Center between the years 1990 and 2008 were retrieved. Clinical information and laboratory parameters were obtained from medical records. PTLD were histologically classified according to current World Health Organization criteria.
Results: Among 4545 cases with solid-organ transplantation between 1990 and 2008, 0.83% (38/4545) patients developed heterogeneous types of PTLD at the time of present study. The cumulative incidence during this period was 1.79% (4/223) for heart recipients, 0.78% (17/2192) for kidney recipients, and 0.82% (17/2067) for liver recipients in each.The median interval between transplantation and PTLD was 44 months. 13 (31.7%) patients presented with PTLDs within 1 year of transplant (early PTLD). The 72.5% of PTLD cases involved extranodal sites. The types of PTLDs included 13.6% of early lesion, 22.7% of polymorphic PTLD, 50% of monomorphic PTLD. 72.5% of PTLD lesion showed EBV-infection. 76.9% (30/39) of patients were in Ann-Arbor stage I-II at the time of diagnosis. The mean overall survival (OS) was 106 months. One patient died of PTLD, 13 (31%) patients died due to allograft failure, or sepsis. 28 (66.7%) patients survived with no evidence of PTLD. Patients with age>60 years old showed the shorter OS time as compared to younger patients (P<0.001). Monomorphic type PTLD (P=0.05), and late-onset (after 1year of transplant) cases (P=0.08) also reduced OS.
Conclusions: Age more than 60 years old, monomorphic type NHL histology, late-onset PTLD might be poor prognostic factors for overall survival.
Monday, March 22, 2010 1:00 PM
Poster Session II # 133, Monday Afternoon