Donor or Recipient Origin of Posttransplant Lymphoproliferative Disorders Following Solid Organ Transplantation

• Published in: American journal of transplantation Vol. 14; no. 12; pp. 2838 - 2845
• Main Authors: Kinch, A., Cavelier, L., Bengtsson, M., Baecklund, E., Enblad, G., Backlin, C., Thunberg, U., Sundström, C., Pauksens, K.
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley 01-12-2014; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Cancer/malignancy/neoplasia: hematogenous/leukemia/lymphoma; Cell of origin; Child; Child, Preschool; Cohort Studies; Donor; Epstein-Barr virus; Female; Fluorescence in situ hybridization; Follow-Up Studies; Graft; Graft vs Host Disease - diagnosis; Graft vs Host Disease - etiology; Hematologic and hematopoietic diseases; hematology/oncology; HLA Antigens - genetics; HLA typing; Humans; In Situ Hybridization, Fluorescence; Infant; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Loss of Y chromosome; Lymphoma; Lymphoproliferative Disorders - diagnosis; Lymphoproliferative Disorders - etiology; Male; Medical Science; Medical sciences; Medicinsk vetenskap; Middle Aged; Organ Transplantation - adverse effects; Postoperative Complications; posttransplant lymphoproliferative disorder (PTLD); Posttransplant lymphoproliferative disorders; Prognosis; PTLD; Recipient; Risk Factors; Solid Organ Transplantation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue Donors; translational research/science; Transplant Recipients; Young Adult; Suboptimal donor; Human; Origin; Solid organ; Malignant hemopathy; Recipient; Transplantation; Homotransplantation; Treatment; Posttransplant lymphoproliferative disorder; Surgery; Lymphoproliferative syndrome; Graft; Cancer; Cancer/malignancy/neoplasia: hematogenous/leukemia/lymphoma; translational research/science; posttransplant lymphoproliferative disorder (PTLD); hematology/oncology
• ISSN: 1600-6135; 1600-6143; 1600-6143
• DOI: 10.1111/ajt.12990

Previous studies of donor or recipient origin of posttransplant lymphoproliferative disorders (PTLDs) following solid organ transplantation (SOT) have either been small or with selected patient groups. We studied tumor origin in a population‐based cohort of 93 patients with PTLD following SOT. Tumor origin of PTLD tissue was analyzed by fluorescence in situ hybridization of the sex chromosomes in cases of sex mismatch between donor and recipient (n = 41), or HLA genotyping in cases of identical sex but different HLA type (n = 52). Tumor origin of PTLD could be determined in 67 of the 93 cases. All 67 PTLDs were of recipient origin. They were found in recipients of kidney (n = 38), liver (n = 12), heart (n = 10) and lung (n = 7). The most common recipient‐derived lymphomas were monomorphic B‐cell PTLDs (n = 45), monomorphic T cell PTLDs (n = 9), indolent lymphomas (n = 6), and polymorphic PTLD (n = 4). Half of the recipient‐derived PTLDs were Epstein–Barr virus‐positive. Twelve of the recipient‐derived PTLDs were located in the grafts: in four cases exclusively and in eight cases in combination with disseminated disease outside the graft. Tumor origin was indeterminable in 26 cases, probably due to low DNA quality. We conclude that the vast majority of PTLDs after SOT was of recipient origin.
Using fluorescence in situ hybridization and HLA genotyping in a population‐based cohort of 93 patients following solid organ transplantation, the authors report that the vast majority of posttransplant lymphoproliferative disorders are of recipient origin.