Posttransplant Lymphoproliferative Disorder After Solid Organ Transplant: A Heterogeneous, Aggressive Disorder
| Autor: | Michael Fay, Derville O’ Shea, Anne Fortune, Liam Smyth, Su Wai Maung, Ronan Desmond, DG Connaghan, Laura McDonald, Catherine Wall, Eoghan Dunlea, Kamal Fadalla, Helen Enright, Eileen Ryan, Sarah Kelliher, Senthil Kumar, Roseann O’ Doherty |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Proliferation index medicine.medical_treatment Salvage therapy Gastroenterology 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Internal medicine medicine Humans Postoperative Period Stage (cooking) Aged business.industry Immunosuppression Hematology Organ Transplantation Middle Aged medicine.disease Confidence interval Lymphoproliferative Disorders Lymphoma Oncology 030220 oncology & carcinogenesis Female Complication business Diffuse large B-cell lymphoma 030215 immunology |
| Zdroj: | Clinical lymphoma, myelomaleukemia. 21(10) |
| ISSN: | 2152-2669 |
| Popis: | Posttransplant lymphoproliferative disorder (PTLD) is a rare complication of solid organ transplant. We identified 40 patients diagnosed with PTLD between 2009 and 2020 and analyzed their presentation, treatment strategies, and outcomes. Median age at diagnosis was 52.5 years (range 21.3 to 79). Median duration of immunosuppression was 95 months (range 4 to 292). Diffuse large B cell lymphoma (n = 16, 40%) and Burkitt lymphoma (n = 6, 15%) were the most common histological subtypes. First-line therapy varied. The median number of treatment lines was 1 (range 0 to 4). Sixteen patients (40%) achieved complete response after first-line therapy. Nineteen patients (47.5%) relapsed or progressed and received salvage therapy; 45% were alive at the end of the study period (median survival 52 months; range 1 to 266; 95% confidence interval 0 to 104). Causes of death included lymphoma-related (45.5%), therapy-related (27.3%), and other (27.3%). Five (22.7%) died within 3 months of diagnosis. Pearson's r test identified disease stage (P = .045) and proliferation index (P = .005) as negative predictors of response to frontline therapy. Bone marrow involvement (P = .033) and increased age (P = .018) were significant predictors of survival. Early mortality and poor response to frontline therapy are common, outlining the need for improved treatment strategies. |
| Databáze: | OpenAIRE |
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