Burkitt lymphoma after solid‐organ transplant: Treatment and outcomes in the paediatric PTLD collaborative

Abstract

Burkitt lymphoma arising in paediatric post-solid-organ transplantation-Burkitt lymphoma (PSOT-BL) is a clinically aggressive malignancy and a rare form of posttransplant lymphoproliferative disorder (PTLD). We evaluated 35 patients diagnosed with PSOT-BL at 14 paediatric medical centres in the United States. Median age at organ transplantation was 2.0 years (range: 0.1-14) and age at PSOT-BL diagnosis was 8.0 years (range: 1-17). All but one patient had late onset of PSOT-BL (≥2 years post-transplant), with a median interval from transplant to PSOT-BL diagnosis of 4.0 years (range: 0.4-12). Heart (n = 18 [51.4%]) and liver (n = 13 [37.1%]) were the most frequently transplanted organs. No patients had loss of graft or treatmentrelated mortality. A variety of treatment regimens were used, led by intensive Burkitt lymphoma-specific French-American-British/Lymphomes Malins B (FAB/ LMB), n = 13 (37.1%), and a low-intensity regimen consisting of cyclophosphamide,

Outcomes of children treated for multiple Epstein–Barr virus‐associated post‐transplant tumors

“…The presence of differing histology and/or SMTs suggests these tumors may be second primaries rather than true recurrences, likely due to ongoing chronic immunosuppression rather a resistant tumor as seen in patients without immunosuppression. This occurrence has been documented in other studies as well, although in very small numbers 22,23 . Genomic studies of the initial and recurrent tumors may be informative in terms of understanding clonal origins and evolution of this disease and identifying any molecular changes that are associated with recurrent tumors or potential targetable mutations.…”

“…This occurrence has been documented in other studies as well, although in very small numbers. 22,23 Genomic studies of the initial and recurrent tumors may be informative in terms of understanding clonal origins and evolution of this disease and identifying any molecular changes that are associated with recurrent tumors or potential targetable mutations.…”

Monomorphic Post-Transplant Lymphoproliferative Disorder in Pediatric Solid Organ Transplant Recipients: Treatment Approach Across Canada

“…32 Although CTLs were not administered to patients in our cohort, it is conceivable that future management will shift to favor novel therapies, alongside aforementioned risk-stratification tools to identify children expected to derive significant benefit from polychemotherapy. [24][25][26][32][33][34] As a retrospective study, recall bias may have impacted data collected. Further, larger Canadian pediatric centers participated but smaller centers did not, this could limit generalizability of our findings.…”

Treatment of Monomorphic Posttransplant Lymphoproliferative Disorder in Pediatric Solid Organ Transplant: A Multicenter Review

“…EBV-CTLs have induced remission in pediatric patients with EBV-positive PTLD after SOT and an industry-sponsored EBV-CTL study is currently recruiting children with PTLD, with results awaited 26 . It is conceivable that future management will shift to favor novel therapies, alongside the aforementioned risk-stratification tools to identify children expected to derive significant benefit from chemotherapy 22,23,27,28 …”

“…26 It is conceivable that future management will shift to favor novel therapies, alongside the aforementioned risk-stratification tools to identify children expected to derive significant benefit from chemotherapy. 22,23,27,28…”