Incidence and clinical characteristics of posttransplant lymphoproliferative disorders: report from a single center

In the period 1973‐1998, among 2139 allograft recipients treated with standard immunosuppression, posttransplant lymphoproliferative disorders (PTLD) developed in 19 patients (0.9%): one plasmacytic hyperplasia, two polymorphic PTLD, one myeloma, and 15 lymphomas. PTLD developed 1 year after transpl...

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Bibliographic Details
Published in:Transplant international 2000-06, Vol.13 (S1), p.S382-S387
Main Authors: Muti, G., Gasperi, A., Cantoni, S., Oreste, P., Gini, G., Civati, G., Busnach, G., Brando, B., Frigerio, M., Mangiavacchi, M., Alberti, A., Decarus, L., Rondinara, G., Giuli, E., Morra, E.
Format: Article
Language:English
Subjects:
acyclovir
Autopsy
Chemotherapy
Complications
Hyperplasia
Immunosuppression
Infection
Lymphoma
Myeloma
posttransplant lymphoproliferative disorders
PTLD
Remission
Running
Surgery
Transplantation
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Summary:In the period 1973‐1998, among 2139 allograft recipients treated with standard immunosuppression, posttransplant lymphoproliferative disorders (PTLD) developed in 19 patients (0.9%): one plasmacytic hyperplasia, two polymorphic PTLD, one myeloma, and 15 lymphomas. PTLD developed 1 year after transplantation (tx) in 14 patients. Five patients were diagnosed at autopsy, 2 were lost to follow up, 3 died before therapy could be instituted, and 1 patient has just started chemotherapy. Of the 8 evaluable patients, 2 received acyclovir and are alive in complete remission (CR) and 6 received chemotherapy ± surgery. Of these 6, 4 died of lymphoma and/or infection, 1 died of unrelated causes in CR, and 1 is alive in CR. PTLD is a severe complication of tx, usually running an aggressive course which may preclude prompt diagnosis and treatment. Nevertheless, therapy is feasible and must be tailored on the histologic subtype. Seventy‐four percent of patients were diagnosed with late‐onset PTLD stressing the need for long‐term follow up.
ISSN:0934-0874
1432-2277
DOI:10.1111/j.1432-2277.2000.tb02066.x