Lymphoma after living donor kidney transplantation: an Iranian multicenter experience

Pourfarziani, Vahid; Taheri, Saeed; Lessan‐Pezeshki, Mahboob; Nourbala, Mohammad Hossein; Simforoosh, N.; Nemati, Eghlim; Makhdoomi, Khadijeh; Ghafari, A.; Pedram, Ahmadpour; Nafar, Mohsen; Einollahi, Behzad

doi:10.1007/s11255-008-9377-0

Cited by 15 publications

(6 citation statements)

References 20 publications

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“…This study indicated that the prognosis of transplant recipients with m-PTLD was still poor, with a 5-year survival rate of 59.2%; this was similar to those reported by Lawrence R et al who found a 5-year survival rate in B-cell m-PTLD patients of approximately 53%, and Vahid Pourfarziani et al who observed a 5-year survival rate of 59% in m-PTLD recipients after KT [16,17]. Although most deaths were associated with progressive disease, up to 60% of patients would eventually die from unrelated cause (mainly infections), emphasizing the vulnerability of transplant patients, even in complete remission.…”

Section: Discussionsupporting

confidence: 88%

Monomorphic Post-transplant Lymphoproliferative Disorder After Kidney Transplantation and Hematopoietic Stem Cell Transplantation: Clinicopathological Characteristics, Treatments and Prognostic Factors

Xie

Lin

et al. 2017

Indian J Hematol Blood Transfus

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Post-transplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of lymphoid neoplasms associated with immunosuppression following transplantation. Among PTLDs, monomorphic PTLD (m-PTLD) is the largest category; however, its characteristics and survival outcome are not fully understood because of low incidence. This study enrolled 30 adult patients with m-PTLD after kidney-transplantation (KT, n = 17) and hematopoietic stem cell transplantation (HSCT, n = 13) from January 1998 to December 2014. The incidence rates of m-PTLD were 0.74 and 3.63% in the KT and HSCT groups, respectively. M-PTLD patients in the HSCT group were younger and showed earlier onset, with EBV-encoded small RNAs (EBER) more frequently identified. Diffuse large B cell lymphoma (DLBCL) was the main pathological type, and the digestive system was the most extranodal involvement site in m-PTLD after KT and HSCT. Among the 28 patients with DLBCL m-PTLD,the complete remission rate after rituximab treatment was higher than in patients not administered rituximab treatment ( = 0.038). With a median follow-up of 46 months after m-PTLD diagnosis, the estimated 5-year overall survival (OS) was 59.2 ± 9.1% in all patients, and 64.2 ± 11.8 and 52.7 ± 14.1% in the KT and HSCT groups, respectively ( = 0.741). ECOG PS, Ann Arbor stage, and CD68 IHC expression were independent prognostic factors for OS. M-PTLD is a rare but serious complication after transplantation. Ongoing efforts to standardize safe and effective treatment protocols would improve the poor overall survival. The independent prognostic factors contributed to risk-stratified treatment, and might be validated by larger studies.

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Section: Discussionsupporting

confidence: 88%

Monomorphic Post-transplant Lymphoproliferative Disorder After Kidney Transplantation and Hematopoietic Stem Cell Transplantation: Clinicopathological Characteristics, Treatments and Prognostic Factors

Xie

Lin

et al. 2017

Indian J Hematol Blood Transfus

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“…MMF is reported to be associated with primary central nervous system lymphomas, and azathioprine has been associated with lymphoproliferative disorders. [89][90][91] In a study of patients after renal transplantation, the 10-year cumulative incidence of first cancer, first skin cancer, and first solid organ cancer was 24.6%, 14.5%, and 14.5%, respectively. There was no significant difference between the immunosuppressive drugs used.…”

Section: Opportunistic Infections Malignancies and Immunosuppressivmentioning

confidence: 99%

Treatment of autoimmune hepatitis: A review of current and evolving therapies

Jothimani

Cramp

Mitchell

et al. 2011

J of Gastro and Hepatol

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Autoimmune hepatitis (AIH) is an immune-mediated necroinflammatory condition of the liver. Presentation can vary from the asymptomatic individual with abnormal liver function test to fulminant liver failure. The diagnosis is based on the combination of biochemical, autoimmune, and histological parameters, and exclusion of other liver diseases. Standard therapy consists of a combination of corticosteroids and azathioprine, which is efficacious in 80% of patients. Alternative therapies are increasingly being explored in patients who do not respond to the standard treatment and/or have unacceptable adverse effects. This review examines the role of alternative drugs (second-line agents) available for AIH treatment non-responders. These agents include budesonide, mycophenolate mofetil, cyclosporin, tacrolimus, 6-mercaptopurine, 6-thioguanine, rituximab, ursodeoxycholic acid, rapamycin, and methotrexate. In addition, the risk of opportunistic infections and malignancies are discussed. A treatment algorithm is proposed for the management of patients with AIH treatment non-responders.

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“…Reported reasons for this high incidence include EpsteinBarr virus (EBV) infection, greater levels of immunosuppression, and use of OKT3, antilymphoblast globulin (ALG), and antithymocyte globulin (ATG) [5][6][7]. Investigators have suggested that the incidence, time interval, presentation, and prognosis of PTLD vary depending on the organ transplanted, recipient age, and immunosuppression intensity [8][9][10][11][12][13][14][15][16]. The reported incidence of PTLD in liver recipients ranges from 1.7 to 9%, with most cases occurring within the first 1.5 years after transplantation [2][3][4][5][6][7][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Hepatic involvement by lymphoproliferative disorders post liver transplantation: PTLD.Int. Survey

Izadi

Fazel²,

Saadat

et al. 2011

Hepatol Int

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Lymphoma after living donor kidney transplantation: an Iranian multicenter experience

Abstract: PTLD is a major threat to kidney transplant recipients. Immunosuppressive agents have a significant role in developing the disease. Early detection of the disease and using more safe immunosuppresants may have beneficial effects on patient outcomes and incidence of the disease.

Cited by 15 publications

References 20 publications

Monomorphic Post-transplant Lymphoproliferative Disorder After Kidney Transplantation and Hematopoietic Stem Cell Transplantation: Clinicopathological Characteristics, Treatments and Prognostic Factors

Monomorphic Post-transplant Lymphoproliferative Disorder After Kidney Transplantation and Hematopoietic Stem Cell Transplantation: Clinicopathological Characteristics, Treatments and Prognostic Factors

Treatment of autoimmune hepatitis: A review of current and evolving therapies

Hepatic involvement by lymphoproliferative disorders post liver transplantation: PTLD.Int. Survey

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