Malignant Neoplasms Following Cardiac Transplantation

Krikorian, John G.; Anderson, Jeffrey L.; Bieber, Charles P.; Penn, Israel; Stinson, Edward B.

doi:10.1001/jama.1978.03290070041012

Cited by 76 publications

(31 citation statements)

References 6 publications

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“…Nevertheless, there are several noteworthy differences between our cohort and the 39 cases of PT-PCNSL reported in the English language literature. Of the 39 reported patients, only 4 had cardiac transplantation and most had renal transplantation (Barnett and Schwartz, 1974;Ciancio et al, 1997;Donnelly et al, 1998;Hardwidge et al, 1990;Krikorian et al, 1978;Kwan et al, 1992;Matas et al, 1976;Miller et al, 1997;Morrison et al, 1994;Murray et al, 1986;Penn et al, 1969;Penn, 1970, 1971;Starlz, 1972a, 1972b;Schwechheimer et al, 1994;Tubman et al, 1983;van Diemen-Steenvoorde et al, 1986;Weintraub and Warnke, 1982). The patients in our cohort were older, and there was no sex bias in our series and no sex bias in the reported cases.…”

Section: Discussionmentioning

confidence: 99%

“…None of our patients were children or adolescents, but 6 of the 39 reported patients were younger than 14 years (Penn et al, 1969). Altogether, only 5 of the 39 patients had onset of PT-PCNSL more than 36 months after transplantation (Barnett and Schwartz, 1974;Ciancio et al, 1997;Donnelly et al, 1998;Hardwidge et al, 1990;Kwan et al, 1992;Krikorian et al, 1978;Matas et al, 1976;Miller et al, 1997;Morrison et al, 1994;Murray et al, 1986;Starlz, 1972a, 1972b;Penn et al, 1969;Penn, 1970, 1971;Schwechheimer et al, 1994;Tubman et al, 1983;van Diemen-Steenvoorde et al, 1986;Weintraub and Warnke, 1982). The predominance of cases of PT-PCNSL among patients with kidney or kidney and pancreas transplants in our cohort and in those reported in the literature may represent a selection bias (these transplantations have been performed for a longer period and more frequently than for other organs).…”

Section: Discussionmentioning

confidence: 99%

“…If there was no evidence of ef cacy, the patients were offered whole-brain radiotherapy. Outcome was determined by the duration of survival and the clinical These patients' characteristics were summarized from previous reports on posttransplant primary CNS lymphoma (Barnett and Schwartz, 1974;Ciancio et al, 1997;Donnelly et al, 1998;Hardwidge et al, 1990;Krikorian et al, 1978;Kwan et al, 1992;Matas et al, 1976;Morrison et al, 1994;Murray et al, 1986;Starlz, 1972a, 1972b;Penn et al, 1969;Schneck and Penn, 1970;Schwechheimer et al, 1994;Tubman et al, 1983;van Diemen-Steenvoorde et al, 1986;Weintraub and Warnke, 1982).…”

Section: Methodsmentioning

confidence: 99%

“…Although posttransplant systemic non-Hodgkin's lymphoma has been amply described, PT-PCNSL has been described in isolated case reports or as part of cohorts of posttransplant non-Hodgkin's lymphoma (Barnett and Schwartz, 1974;Ciancio et al, 1997;Donnelly et al, 1998;Hardwidge et al, 1990;Krikorian et al, 1978;Kwan et al, 1992;Matas et al, 1976;Miller et al, 1997;Morrison et al, 1994;Murray et al, 1986;Starlz, 1972a, 1972b;Penn et al, 1969;Penn, 1970, 1971;Schwechheimer et al, 1994;Tubman et al, 1983;van Diemen-Steenvoorde et al, 1986;Weintraub and Warnke, 1982). Only 39 such cases have been published in the English language literature (Table 1), and most of these antedate modern neuro-imaging.…”

Section: P T-pcnslmentioning

confidence: 99%

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Posttransplant primary CNS lymphoma

Phan¹

2000

Neuro-Oncology

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The records and neuro-imaging studies of 8 cases of posttransplant primary CNS lymphoma (PT-PCNSL) diagnosed at Mayo Clinic Rochester between 1970 and 1998 were reviewed retrospectively. All patients received organ transplantation. Patients who had hematologic transplantation were not included in the analysis. The median and mean age of the 4 men and 4 women was 45 years (range, 34 to 50 years). The median duration of symptoms before diagnosis was 36 days (range, 5 to 98 days). At diagnosis, the neurologic examination was focally abnormal in 6 of 8 patients. Compared with the initial computed tomographic study, MRI showed 25 additional brain lesions. Only 43.7% of lesions enhanced with contrast agent; of those that did, all but one were heterogeneous. Ependymal contact occurred in 5 patients. MRI lesion burden increased proportionally to the interval between scans. Diagnostic tissue was obtained by stereotactic biopsy from 6 patients and by open biopsy from 2. Hemorrhage occurred in the biopsy area in 4 patients who had stereotactic biopsy and 2 died (all had normal coagulation studies). Slides available for review (7 patients) showed that the tumors were of CD20-positive lineage and were positive for Epstein-Barr virus, using in situ hybridization. Six patients died. Median survival for the cohort was 13 weeks. PT-PCNSL has clinical and imaging features distinct from typical PCNSL. In our series, (1) PT-PCNSL presented nonspeci cally and progressed rapidly, (2) stereotactic brain biopsy had signi cant morbidity, and (3) despite multimodal therapy, survival was poor. NeuroOncology 2, 229-238, 2000 (Posted to Neuro-Oncology [serial online], Doc. 00-034, September 13, 2000

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: P T-pcnslmentioning

confidence: 99%

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Posttransplant primary CNS lymphoma

Phan¹

2000

Neuro-Oncology

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“…7,[9][10][11][12][13][14][15][16][17][18][19] One patient with AML out of a series of 124 cardiac allograft recipients has been reported. 20 AML as a complication of lung or liver transplantation has not been described yet. The therapeutic options for all of these malignancies are hampered by a high therapy-related mortality, which is due to poor hematologic tolerance to chemotherapy, as well as to frequent infections resembling those in other immunocompromised patients.…”

Section: Introductionmentioning

confidence: 99%

Post-transplant acute myeloid leukemia (PT-AML)

et al. 1999

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Acute myeloid leukemia following organ transplantation (PT-AML) is a rare event with only a few published cases in the literature. We present three patients who developed AML (FAB M1, M5, M4) after renal, double lung or liver transplantation. Molecular analysis detected a t(9;11) in one patient and documented the recipient origin of AML in a second patient. All patients were treated with chemotherapy. Immunosuppression was reduced to cyclosporin A (CsA) and prednisone in two patients and to prednisone alone in one patient. Two patients achieved a complete remission (CR), with a remission duration of 4.6 months in one patient, the other patient died from septicemia after 15.2 months in CR. One patient was refractory to chemotherapy and died from septicemia. This report together with the documented cases in the literature suggests that PT-AML (1) develops after a median interval of 5 years after transplantation with variable latency (range, Ͻ1-17 years); (2) is heterogeneous with respect to FAB classification; (3) shows chromosomal and molecular changes typical of therapy-related AML (t-AML: −7, +8, 11q23, inv16, t(15;17)); (4) standard chemotherapy is feasible after reduction of immunosuppression and produces a CR rate of 56% with a median remission duration of 4.6 months and an overall survival of 2.6 months; (5) the major complications are early death (25%), Gram-negative septicemia, progressive disease or relapse. This review provides diagnostic and therapeutic experiences and guidelines for the management of this increasing group of post-transplant patients.

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Malignant tumors in renal transplant patients the scandia transplant material

Birkeland

1983

Cancer

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In Scandinavia, between 1956 and 1974, 2672 kidney transplantations were performed on 2272 patients. Until 1974, 39 de novo malignant tumors were diagnosed among the 1872 patients who received their first and only graft in the period, and among the entire group of patients an additional 58 tumors were diagnosed until 1978; over 1/4 of these tumors were of mesenchymal origin and of these, over one half were reticulosarcomata, and one half were cerebral. Among 566 Danish recipients who received their first and only graft in the period 1969–1974, there was a highly significantly (P < 0.00001) increased tumor incidence in relation to the background population. A significant (P < 0.0005) relationship was found between the occurrence of tumors and human leukocyte antigen (HLA) mismatch. In the entire material no correlation was found to the number of transplantations given to the individual patient; there were significantly (P < 0.01) more tumors in recipients of necrokidneys compared with related kidneys; and there was a significant (P < 0.006) overrepresentation of recipients with chronic interstitial nephritis.

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Malignant Neoplasms Following Cardiac Transplantation

Cited by 76 publications

References 6 publications

Posttransplant primary CNS lymphoma

Posttransplant primary CNS lymphoma

Post-transplant acute myeloid leukemia (PT-AML)

Malignant tumors in renal transplant patients the scandia transplant material

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