Epidemiology of posttransplantation lymphoproliferative disorder in adult renal transplant recipients
| Autor: | Kate Ryan, Paul E. Klapper, M. Picton, Stephen A Roberts, Richard J. Byers, P. J. Vallely, B. Coupes, Muir Morton |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Epstein-Barr Virus Infections Herpesvirus 4 Human Population Comorbidity Kaplan-Meier Estimate Antibodies Viral Gastroenterology Cohort Studies Internal medicine hemic and lymphatic diseases Epidemiology Medicine Humans Epstein-Barr virus Postoperative Period education Survival rate Aged Retrospective Studies education.field_of_study Transplantation business.industry Incidence (epidemiology) Incidence Lymphoma Non-Hodgkin Retrospective cohort study Renal transplantation Middle Aged medicine.disease Hodgkin Disease Kidney Transplantation Lymphoproliferative Disorders United Kingdom Lymphoma Survival Rate surgical procedures operative PTLD DNA Viral Female business |
| Zdroj: | Morton, M, Coupes, B, Roberts, S, Klapper, P E, Byers, R J, Vallely, P J, Ryan, K & Picton, M L 2013, ' Epidemiology of posttransplantation lymphoproliferative disorder in adult renal transplant recipients. ', Transplantation, vol. 95, no. 3, pp. 470-478 . https://doi.org/10.1097/TP.0b013e318276a237 |
| DOI: | 10.1097/TP.0b013e318276a237 |
| Popis: | BACKGROUND: There is little information in the literature describing the relationship between posttransplantation lymphoproliferative disorder (PTLD) incidence and presentation with both recipient Epstein-Barr virus (EBV) serostatus and EBV status of PTLD histology, particularly in the late posttransplantation period. METHODS: This study reports the largest UK single-center, single-organ analysis of PTLD to date in a retrospective cohort study of 80 cases occurring in 4189 adult renal transplant recipients. RESULTS: The incidence rate was 2.6 cases per 1000 patient-years (95% confidence interval [95% CI], 2.1-3.2) for PTLD, 1.8 (95% CI, 1.4-2.4) for non-Hodgkin's lymphoma, and 0.2 (95% CI, 0.07-4.2) for Hodgkin's lymphoma. Non-Hodgkin's lymphoma occurred at a rate 7.6 times that of the adult general population in England, whereas the rate for Hodgkin's lymphoma was 5.9 times. The incidence of PTLD was highest during the 10th to 14th posttransplantation years. Early-onset disease was associated with EBV-seronegative recipient status, EBV-positive histology, and the involvement of extranodal sites. PTLD occurring in EBV-seronegative recipients was associated with EBV nuclear antigen antibody deficiency, polymorphic disease, and the involvement of extranodal sites. EBV-negative histology occurred in 32% of cases at a median time to presentation of 109 months. PTLD involving the allograft, central nervous system, and skin was uncommon and occurred late. CONCLUSION: The incidence of PTLD is highest in the late posttransplantation period. Close clinical surveillance and education for transplant recipients is required for the duration of time while immunosuppressed. Failure to detect EBV DNA in blood should not reassure, particularly in patients with symptoms such as abdominal pain, oropharyngeal complaints, neck lumps, and B-symptoms. |
| Databáze: | OpenAIRE |
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