J Korean Med Sci.  2006 Apr;21(2):259-264. 10.3346/jkms.2006.21.2.259.

Clinical Characteristics and Outcomes of Posttransplant Lymphoproliferative Disorders Following Allogeneic Hematopoietic Stem Cell Transplantation in Korea

• Park SH
• Choi SM
• Lee DG
• Choi JH
• Yoo JH
• Kim HJ
• Kim DW
• Lee JW
• Min WS
• Shin WS
• Kim CC

• KMID: 1781832
• DOI: http://doi.org/10.3346/jkms.2006.21.2.259

Abstract

Between 1995 and 2003, seven cases of posttransplant lymphoproliferative disorder (PTLD) were identified among 1,116 patients who received allogeneic hematopoietic stem cell transplantations (HSCT) at Catholic HSCT Center (overall incidence 0.6%). Five (71.4%) patients had episodes of acute graft-versus-host-disease (GVHD) and were treated with steroids. Cervical lymphadenopathy was observed in most cases (71.4%), but clinical symptoms varied depending on the involved sites. Pathologic findings varied: 1 case of plasmacytic hyperplasia, 3 of polymorphic PTLD, 2 of diffuse large B-cell lymphoma, 1 of large T-cell lymphoma, which proved to be associated with Epstein-Barr virus (EBV). The proportion of EBV-negative PTLD was 33.3%. Five patients demonstrated a good response to treatment (treatment response rate 71.4%). The overall mortality was 42.8%, and one death was directly attributable to PTLD. The incidence of PTLD is expected to increase, based on the rising use of grafts from alternative donors and recent clinical features of PTLD manifested by a disseminated and fulminant nature. It is necessary to have a high level of suspicion when monitoring patients and readily adopt prompt and effective cellular immunotherapy for PTLD.

Keyword

Lymphoproliferative Disorders; Hematopoietic Stem Cell Transplantation; Transplantation; Homologous

MeSH Terms

Transplantation, Homologous
Middle Aged
Male
Lymphoproliferative Disorders/*etiology/pathology/therapy
Lymphoma, T-Cell/etiology
Lymphoma, Large-Cell, Diffuse/etiology
Lymphoma, Large-Cell/etiology
Lymphoma, B-Cell/etiology
Korea
Humans
Hematopoietic Stem Cell Transplantation/*adverse effects
Female
Epstein-Barr Virus Infections/etiology
Adult
Adolescent

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