Low 5-year cumulative incidence of post-transplant lymphoproliferative disorders after solid organ transplantation in Switzerland

Autor: Steiner, Raphael E, Kridel, Robert, Giostra, Emiliano, McKee, Thomas A, Achermann, Rita, Mueller, Nicolas J, Manuel, Oriol, Dickenmann, Michael, Schuurmans, Macé M, de Leval, Laurence, Fehr, Thomas, Tinguely, Marianne, Binet, Isabelle, Cogliatti, Sergio, Haralamvieva, Eugenia, Koller, Michael, Swiss Transplant Cohort Study, Dietrich, Pierre-Yves
Přispěvatelé: University of Zurich, Steiner, Raphael E, The Swiss Transplant Cohort Study Stcs
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Adult
Male
Pediatrics
medicine.medical_specialty
Time Factors
Lymphoma
Immunosuppression/methods
medicine.medical_treatment
610 Medicine & health
2700 General Medicine
ddc:616.07
Post-transplant lymphoproliferative disorder
10234 Clinic for Infectious Diseases
Postoperative Complications
Switzerland/epidemiology
Risk Factors
hemic and lymphatic diseases
medicine
Humans
Cumulative incidence
Female
Incidence
Kidney Transplantation/statistics & numerical data
Lymphoma/complications
Lymphoproliferative Disorders/diagnosis
Lymphoproliferative Disorders/epidemiology
Lymphoproliferative Disorders/etiology
Retrospective Studies
Immunosuppression Therapy
ddc:616
business.industry
Incidence (epidemiology)
Immunosuppression
Retrospective cohort study
General Medicine
medicine.disease
Kidney Transplantation
Lymphoproliferative Disorders/diagnosis/epidemiology/etiology
Lymphoproliferative Disorders
Transplantation
surgical procedures
operative
Cohort
10178 Clinic for Pneumology
business
Switzerland
Cohort study
Zdroj: Swiss Medical Weekly, Vol. 148 (2018) P. w14596
Swiss medical weekly, vol. 148, pp. w14596
ISSN: 1424-7860
Popis: Background Post-transplant lymphoproliferative disorder (PTLD) is a potentially life-threatening complication of transplantation occurring in the setting of immunosuppression and oncogenic viral infections. However, little is known about the cumulative incidence, histological subtypes, risk determinants and outcome of PTLD in solid organ transplant (SOT) recipients in Switzerland. Methods This retrospective observational study investigated adult SOT recipients from two sequential cohorts, the pre-SCTS (Swiss Transplant Cohort Study) series, with data collected from January 1986 to April 2008, and the STCS series, with data collected from May 2008 to December 2014 in Switzerland. SOT recipients were cross-referenced with the data of all the patients with a lymphoma diagnosis in each transplant centre and with the data of the Swiss Transplant Cohort Study (STCS) to determine the cumulative incidence of PTLD, pre-therapeutic clinical features, clinical course and outcome. Kaplan-Meier analysis was performed for overall survival after PTLD. Results We identified 79 cases of PTLD during the study period in the two cohorts: pre-STCS from 1986 to 2008 (n = 62) and STCS from 2008 to 2014 (n = 17). Histological subgroups included: early lesions (pre-STCS n = 2, STCS n = 0); polymorphic PTLD (pre-STCS n = 8, STCS n = 7); monomorphic PTLD (pre-STCS n = 47, STCS n = 10), and Hodgkin's lymphoma (pre-STCS n = 5, STCS n = 0). Median time to PTLD diagnosis was 90 months (range 3-281 months) and 14 months (range 2-59 months) in the pre-STCS and STCS cohorts, respectively. Median follow-up after transplantation was 141 months for the pre-STCS patients and 33 months for the STCS patients. Cumulative incidences of PTLD during the STCS period at 0.5, 1 and 5 years were 0.17% (95% confidence interval 0.07-0.46%), 0.22% (0.09-0.53%) and 0.96% (0.52-1.80%), respectively. For the pre-STCS case series, it was not possible to estimate the incidence rate of PTLD. Survival after PTLD diagnosis was 80% (68-87%) at 1 year and 56% (42-68%) at 5 years for the pre-STCS and STCS cohorts combined. Conclusions At 5 years, the cumulative incidence of PTLD, regardless of the organ transplanted, was only 0.96% in the STCS cohort, which is lower than that reported in the literature.
Databáze: OpenAIRE
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