J Korean Med Sci.  2010 Apr;25(4):523-526. 10.3346/jkms.2010.25.4.523.

Clinical Characteristics of Monomorphic Post-transplant Lymphoproliferative Disorders

• Choi JH
• Park BB
• Suh C
• Won JH
• Lee WS
• Shin HJ

• KMID: 1792918
• DOI: http://doi.org/10.3346/jkms.2010.25.4.523

Abstract

Post-transplant lymphoproliferative disorders (PTLD) are a heterogeneous group of lymphoproliferative disorders associated with immunosuppression and Epstein-Barr virus infection. PTLD is classified into three major categories: early lesions, polymorphic PTLD, and monomorphic PTLD. The majority of monomorphic PTLD cases are non-Hodgkin's lymphoma of B-cell origin. This retrospective study was conducted to investigate the incidence, clinical manifestation, treatment, and outcomes of monomorphic PTLD among 5,817 recipients of solid organ or allogeneic hematopoietic stem cell transplantation from five institutions. Fourteen patients with monomorphic PTLD were identified (male:female 11:3; median age 42.6 yr, range 24-60). The overall incidence rate was 0.24%. The most common disease type was diffuse large B cell lymphoma (n=7). The median time between the transplant and diagnosis of PTLD was 85.8 months. However, all cases of PTLD after allogeneic hematopoietic stem cell transplantation occurred within 1 yr after transplantation. Ten of the 14 patients had EBV-positive tumor. Fourteen patients received combination systemic chemotherapy and four patients were treated with radiation therapy. Ten patients achieved a complete response (CR) and two patients a partial response (PR). The median follow-up period for surviving patients was 36.6 months. Nine patients remain alive (eight CR, one PR). Nine of 11 solid organ transplantations preserved graft function. The present study indicates a lower incidence rate and a longer median time before the development of PTLD than those of previous reports. Careful monitoring was needed after allogeneic hematopoietic stem cell transplantation for PTLD.

Keyword

Monomorphic Post-transplant Lymphoproliferative Disorders

MeSH Terms

Adult
Epstein-Barr Virus Infections/complications/immunology
Female
Herpesvirus 4, Human
Humans
Lymphoproliferative Disorders/classification/etiology/immunology/*physiopathology
Male
Middle Aged
Retrospective Studies
Survival Rate
Transplantation, Homologous/*adverse effects/immunology
Treatment Outcome
Young Adult

Figure

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  Fig. 1 Overall survival for all patients.

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