The Impact of the World Health Organization Classification and Clonality Assessment of Posttransplant Lymphoproliferative Disorders on Disease Management
| Autor: | Adher Al Sayed, Yasser Khafaga, Khaled Al Shaibani, Asma Tulabah, Mohamed Al Shabanah, Walid A. Mourad, Adnan Ezzat, Hazem El Gamal, Madras A. Raja, Khaled Al Meshari |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Lymphoproliferative disorders World Health Organization World health Pathology and Forensic Medicine medicine Humans Disease management (health) Child Intensive care medicine Aged Bone Marrow Transplantation Gene Rearrangement business.industry Infant Organ Transplantation General Medicine Middle Aged Flow Cytometry medicine.disease Lymphoproliferative Disorders Genes T-Cell Receptor Medical Laboratory Technology Phenotype Treatment Outcome Child Preschool Immunology Female Immunoglobulin Heavy Chains business |
| Zdroj: | Archives of Pathology & Laboratory Medicine. 130:1649-1653 |
| ISSN: | 1543-2165 0003-9985 |
| Popis: | Context.—The World Health Organization classification of posttransplant lymphoproliferative disorders divides them into 4 main categories. Objective.—To classify cases of posttransplant lymphoproliferative disorders diagnosed in our institution according to the World Health Organization scheme and correlate the classification and clonality with clinical data. Design.—Cases of posttransplant lymphoproliferative disorders were reviewed. They were classified according to the World Health Organization scheme. Clonality was determined by flow cytometry and/or polymerase chain reaction. Patients' charts were reviewed. Results.—Thirty-one cases were identified. Median age was 33 years. There were 19 cases of kidney, 8 cases of liver, and 4 cases of bone marrow transplant. Immunosuppression consisted of cyclosporin A and prednisone (N = 24) or FK506 and prednisone (N = 7). Twenty cases (63%) were World Health Organization type 3, 7 cases (23%) type 2, 3 cases (6.4%) type 1, and 1 case type 4 posttransplant lymphoproliferative disorder. Ten patients received chemotherapy, 20 patients had reduction of immunosuppression, and 1 had no treatment. Follow-up was available on 25 patients. Seven (43.75%) of 16 with type 3 lesions with available follow-up died of their disease. Five of these patients received reduction of immunosuppression alone. Only 2 of 9 patients with type 3 disease who received chemotherapy died of disease. Two patients with type 2 disease died of unrelated causes. One patient is alive with disease; the remaining patients with types 1 and 2 disease are alive with no disease. Conclusions.—The World Health Organization classification of posttransplant lymphoproliferative disorders is valuable in the identification of subtypes. It helps identify early lesions (1 and 2) requiring reduction of immunosuppression and type 3 disease, which requires chemotherapy from the outset. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|