Post‐transplant lymphoproliferative disorder following renal transplantation: A single‐center experience over 40 years

Abstract

Objectives: To investigate post-transplant lymphoproliferative disorder (PTLD) following renal transplantation at our institution. Methods: Medical records of 631 patients who underwent renal transplantation at Osaka University Hospital between March 1965 and December 2008 were reviewed. Results: PTLD following renal transplantation was detected in 10 patients (five men, five women; mean age at transplantation, 38.5 years). Mean duration from renal transplantation to the onset of PTLD was 7.1 years (range, 5 months to 18 years, 9 months). Mean duration of observation was 3.9 years from the onset of PTLD. Immunosuppressant therapy comprised multidrug combination therapy, including cyclosporine in six patients and tacrolimus in four patients. In addition to a reduction in the immunosuppressant dose, which was performed in all patients, PTLD was treated with surgery in seven patients, radiotherapy in two patients, rituximab in five patients, and cytotoxic chemotherapy in four patients. A complete remission in eight patients and progressive disease in two were observed. At last follow up, seven patients were alive and five patients had functioning grafts. Conclusions:The incidence of PTLD following renal transplantation at our institution is 1.6% with onset occurring more than 5 years after transplantation in five patients. Consequently, with long-term renal graft survival now feasible, attention must be paid to detecting late-onset PTLD.

Post‐transplant lymphoproliferative diseases in Asian solid organ transplant recipients: late onset and favorable response to treatment

“…Treatment outcome in our cohort was favorable. In fact, similar observations have been made since the introduction of the monoclonal anti‐CD20 antibody rituximab (7, 11–15). Prior to the use of rituximab, reduction of immunosuppression alone resulted in a poor response rate of only 10–30% (16).…”

“…Data of PTLD from Asian populations are not well reported, and are usually restricted to case reports or series of small number of patients (6, 7). Owing to different demographics, it remains undefined if the types of PTLD and outcome are similar to those of Western patients.…”

Long-Term Complete Remission of Multiple Extranodal Natural Killer/T-cell–Type Posttransplant Lymphoproliferative Disorder After Surgical Resection: A Case Report

“…The existence of PTLD was first introduced in 1984 by Startzl et al [5]. The incidence of PTLD ranges from 1% to 3% in renal transplantation and 5% to 20% in lung and intestinal transplantation [6,7].…”

Post‐Transplant Lymphoproliferative Disorder in Kidney Transplant Recipients: A Single‐Center Experience in Japan

“…In recent years, large‐scale studies for PTLD have been performed and revealed several differences between early‐ and late‐onset PTLD, not only in risk and prognostic factors but also patient and graft outcome. However, the number of such reports has been limited in Asian institutions: to the best of our knowledge, only two retrospective studies of single‐center experience in China and Japan , have been reported.…”