Chemotherapy for Posttransplant Lymphoproliferative Disorder: The Israel Penn International Transplant Tumor Registry Experience

• Published in: Transplantation proceedings Vol. 37; no. 2; pp. 956 - 957
• Main Authors: Buell, J.F., Gross, T.G., Hanaway, M.J., Trofe, J., Muthiak, C., First, M.R., Alloway, R.R., Woodle, E.S.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2005; Elsevier Science
• Subjects: Antigens, CD - blood; B-Lymphocytes - immunology; Biological and medical sciences; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Heart Transplantation - immunology; Heart Transplantation - mortality; Hematologic and hematopoietic diseases; Humans; Kidney Transplantation - immunology; Kidney Transplantation - mortality; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Liver Transplantation - immunology; Liver Transplantation - mortality; Lymphoproliferative Disorders - drug therapy; Male; Medical sciences; Pancreas Transplantation - immunology; Pancreas Transplantation - mortality; Postoperative Complications - drug therapy; Recurrence; Registries; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Tissue, organ and graft immunology; Asia; Israel; Antineoplastic agent; Graft(material); Malignant hemopathy; Transplantation; Homotransplantation; Medicine; Chemotherapy; Treatment; Posttransplant lymphoproliferative disorder; Register; Surgery; Lymphoproliferative syndrome; Graft; Tumor; International
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2004.12.124

Very little published data exist regarding the results of chemotherapy treatment of posttransplant lymphoproliferative disorder (PTLD). The purpose of the study was to review the Israel Penn International Transplant Tumor Registry experience with PTLD treated with chemotherapy.
Patients with PTLD who received chemotherapy were identified and data collected regarding demographics, tumor characteristics, recurrence rates, and survival.
One hundred ninety three solid organ transplant recipients with PTLD who received chemotherapy were identified. Most patients were male (142:51) and Caucasian (148; 16 AA, 29 unspecified). Most PTLD were B-cell predominant (81%), monoclonal (71), and CD 20+ (60% of patients tested). Organ transplanted included: kidney, 92 (48%); heart, 54 (28%); liver, 30 (16%); pancreas, 8 (4%); and lung, 9 (5%). Median time to presentation posttransplant was 24.5 months (range 0.8 to 226.5 months). Ninety patients received CHOP, 12 ProMACE, 65 other multidrug regimens, and 23 patients received single-agent chemotherapy. Five-year survival for these four regimens were: 24%, 25%, 32%, and 5%. PTLD-specific death rates were 34%, 34%, 40%, and 48%.
Single-agent chemotherapy appears to be inferior to other chemotherapy regimens for PTLD as it is associated with lower survival.