Characteristics and Outcome of Post-Transplant Lymphoproliferative Disorders After Solid Organ Transplantation: A Single Center Experience of 196 Patients Over 30 Years

Vergote, Valentijn; Deroose, Christophe M.; Fieuws, Steffen; Laleman, Wim; Sprangers, Ben; Uyttebroeck, Anne; Cleemput, Johan Van; Verhoef, Gregor; Vos, Robin; Tousseyn, Thomas; Dierickx, Daan

doi:10.3389/ti.2022.10707

Cited by 4 publications

(2 citation statements)

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“…previously described an association between hypoalbuminemia and PTLD. Furthermore, Vergote et al 28 . linked hypoalbuminemia to poor outcomes in adult patients with PTLD.…”

Section: Discussionmentioning

confidence: 99%

“…Ozcay et al 26 and Younes et al 27 previously described an association between hypoalbuminemia and PTLD. Furthermore, Vergote et al 28 linked hypoalbuminemia to poor outcomes in adult patients with PTLD. In other observational studies, where nodal presentation predominated especially in pediatric patients who presented later with PTLD, low serum albumin was not a common finding at presentation.…”

Section: Parametersmentioning

confidence: 99%

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Post‐transplant lymphoproliferative disorder in pediatric liver transplant recipients: Experience from a South African transplant center

Walabh,

Moore,

Hajinicolaou

2023

Transplant Infectious Dis

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IntroductionPost‐transplant lymphoproliferative disorder (PTLD) is a clinically heterogeneous potentially fatal complication of pediatric liver transplantation (PLT). We determined the prevalence, complications, and associated factors for PTLD in PLT recipients from Wits Donald Gordon Medical Centre, South Africa from January 2012 to August 2019.MethodsWe performed a retrospective record review of 150 PLT recipients.ResultsHistologically proven PTLD occurred in 17/150 PLT recipients (11.3%). Children with PTLD were significantly younger at transplant (17.9 vs. 32.7 months, p = 0.001) with a significantly higher prevalence of obstructive etiology (17/17 vs. 81/133, p = 0.001). Fifteen (88.2%) children with PTLD were Epstein‐Barr virus (EBV) seronegative at transplant. High post‐transplant EBV viral load at a threshold value of 4.8 log10 DNA copies/mL (sensitivity: 80.0% [95% confidence interval {CI}, 46.7%–100.0%]; specificity: 73.1% [95% CI 42.3%–93.3%; area under the curve {AUC} 75.8%]) and low post‐transplant albumin levels at a threshold value of 21.5 g/L (sensitivity: 70.6% [95% CI, 41.2%–94.1%]; specificity: 85.7% [95% CI, 60.4%–94.5%; {AUC} 74.8%]) were associated with PTLD. The prevalence of cytomegalovirus (CMV) disease was significantly higher in children who developed PTLD versus non‐PTLD (12/17 vs. 18/133; p < 0.001). CMV disease and the combination of post‐transplant high EBV viral load and low albumin were independently associated with an increased risk of developing PTLD. Four (23.5%) children with PTLD died, however, survival was equivalent to non‐PTLD PLT (p = 0.580).ConclusionThe prevalence of PTLD in our cohort mirrors international cohorts, with mortality similar to non‐PTLD PLT recipients. image

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“…previously described an association between hypoalbuminemia and PTLD. Furthermore, Vergote et al 28 . linked hypoalbuminemia to poor outcomes in adult patients with PTLD.…”

Section: Discussionmentioning

confidence: 99%

Section: Parametersmentioning

confidence: 99%

Post‐transplant lymphoproliferative disorder in pediatric liver transplant recipients: Experience from a South African transplant center

Walabh,

Moore,

Hajinicolaou

2023

Transplant Infectious Dis

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Pediatric monomorphic post‐transplant lymphoproliferative disorder with plasmablastic differentiation: A challenge for diagnosis and treatment

Cheng,

Harney,

Toner

et al. 2024

Pediatric Blood & Cancer

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Characterization and outcome of post-transplant lymphoproliferative disorders within a collaborative study

et al. 2023

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BackgroundPost-transplant lymphoproliferative disorders (PTLD) are heterogeneous lymphoid disorders ranging from indolent polyclonal proliferations to aggressive lymphomas that can arise after solid organ transplantation (SOT) and allogeneic hematopoietic transplantation (allo-HSCT).MethodsIn this multi-center retrospective study, we compare patient characteristics, therapies, and outcomes of PTLD after allo-HSCT and SOT. Twenty-five patients (15 after allo-HSCT and 10 after SOT) were identified who developed PTLD between 2008 and 2022.ResultsMedian age (57 years; range, 29-74 years) and baseline characteristics were comparable between the two groups (allo-HSCT vs SOT), but median onset of PTLD was markedly shorter after allo-HSCT (2 months vs. 99 months, P<0.001). Treatment regimens were heterogeneous, with reduction of immunosuppression in combination with rituximab being the most common first-line treatment strategy in both cohorts (allo-HSCT: 66%; SOT: 80%). The overall response rate was lower in the allo-HSCT (67%) as compared to the SOT group (100%). Consequently, the overall survival (OS) trended towards a worse outcome for the allo-HSCT group (1-year OS: 54% vs. 78%; P=0.58). We identified PTLD onset ≤150 days in the allo-HSCT (P=0.046) and ECOG >2 in the SOT group (P=0.03) as prognostic factors for lower OS.ConclusionPTLD cases present heterogeneously and pose unique challenges after both types of allogeneic transplantation.

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Characteristics and Outcome of Post-Transplant Lymphoproliferative Disorders After Solid Organ Transplantation: A Single Center Experience of 196 Patients Over 30 Years

Cited by 4 publications

References 61 publications

Post‐transplant lymphoproliferative disorder in pediatric liver transplant recipients: Experience from a South African transplant center

Post‐transplant lymphoproliferative disorder in pediatric liver transplant recipients: Experience from a South African transplant center

Pediatric monomorphic post‐transplant lymphoproliferative disorder with plasmablastic differentiation: A challenge for diagnosis and treatment

Characterization and outcome of post-transplant lymphoproliferative disorders within a collaborative study

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