Post-transplant lymphoproliferative disorders after solid organ and hematopoietic stem cell transplantation

• Published in: Leukemia & lymphoma Vol. 60; no. 1; pp. 142 - 150
• Main Authors: Romero, Samuel, Montoro, Juan, Guinot, Marta, Almenar, Luis, Andreu, Rafael, Balaguer, Aitana, Beneyto, Isabel, Espí, Jordi, Gómez-Codina, José, Iacoboni, Gloria, Jarque, Isidro, López-Andújar, Rafael, Mayordomo-Aranda, Empar, Montalar, Joaquín, Pastor, Amparo, Pastor, Miguel, Piñana, José L., Rojas-Ferrer, Nohelia, Sánchez-Lázaro, Ignacio, Sandoval, Jesús, Sanz, Guillermo, Sanz, Miguel Á., Solé, Amparo, Sanz, Jaime
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 02-01-2019
• Subjects: Adolescent; Adult; Epstein-Barr virus; Epstein-Barr Virus Infections - epidemiology; Epstein-Barr Virus Infections - etiology; Epstein-Barr Virus Infections - pathology; Female; Graft Rejection - etiology; Graft Rejection - prevention & control; hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - adverse effects; Herpesvirus 4, Human - drug effects; Herpesvirus 4, Human - isolation & purification; Herpesvirus 4, Human - physiology; Humans; immunosuppression; Lymph Nodes - pathology; Lymph Nodes - virology; Lymphoproliferative Disorders - epidemiology; Lymphoproliferative Disorders - etiology; Lymphoproliferative Disorders - pathology; Male; Middle Aged; Organ Transplantation - adverse effects; post-transplant lymphoproliferative disorders; Retrospective Studies; Solid organ transplantation; Survival Analysis; Transplantation Conditioning - adverse effects; Transplantation Conditioning - methods; Transplantation, Homologous - adverse effects; Virus Activation - drug effects; Young Adult; hematopoietic stem cell transplantation; immunosuppression; post-transplant lymphoproliferative disorders; Solid organ transplantation; Epstein–Barr virus
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428194.2018.1474462

Post-transplant lymphoproliferative disorders (PTLD) are a rare complication after both solid organ (SOT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this single center retrospective study, we compared clinical, biological, and histological features, and outcomes of PTLD after both types of transplant. We identified 82 PTLD (61 after SOT and 21 after allo-HSCT). The presence of B symptoms, Waldeyer ring, spleen, central nervous system, and liver involvement, and advanced Ann-Arbor stage were more frequent in allo-HSCT recipients. PTLD had an earlier onset in allo-HSCT than in SOT cohort (4 vs. 64 months, p < .0001). PTLD was EBV-positive in 100% of allo-HSCT, in contrast to 47% of SOT (p = .0002). Four years after PTLD diagnosis, median overall survival was 32% (95% CI, 22-48) and 10% (95% CI, 2-49) in SOT and allo-HSCT recipients, respectively (p = .002). In conclusion, the clinical presentation and the outcome of PTLD varies greatly depending on the type of transplant.