Post-transplant lymphoproliferative disorder in adult lung transplant recipients: A report on twenty-seven patients

Stein, Sybil; Misleh, Jamal; Ahya, Vivek N.; Kotloff, R.M.; Hadjiliadis, D.; Christie, James H.; Loren, Alison W.; Schuster, Sheeja; Stadtmauer, Edward A.; Tsai, D. E.

doi:10.1200/jco.2008.26.15_suppl.19521

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“…The reported incidence of PTLD following lung transplantation generally has been higher than after other type of solid organ transplants, ranging as high as 20% of recipients (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). We observed an incidence of 5% in 639 lung and heart/lung transplant recipients.…”

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confidence: 61%

“…However, the incidence of PTLD is relatively low in this setting and substantially higher in other types of transplant, especially lung and intestinal transplants (2). Thus, although there is a large literature describing PTLD after renal transplantation, there are few studies of PTLD after lung transplantation despite an incidence ranging up to 20% (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Here, we present our experience in 32 patients with PTLD following lung transplantation at the University of Minnesota.…”

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confidence: 99%

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Post‐transplant lymphoproliferative disorders in lung transplant recipients: 20‐yr experience at the University of Minnesota

Wudhikarn¹,

Holman²,

Liñán³

et al. 2010

Clinical Transplantation

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Post-transplant lymphoproliferative disorders (PTLD) are potentially fatal complications of solid organ transplantation. The natural history of PTLD varies considerably among the different types of organs transplanted. While lung transplant recipients are highly susceptible to PTLD, there are only a few small studies that detail PTLD in this setting. We undertook this study to better describe the characteristics and treatment response in PTLD after lung transplantation. We conducted a retrospective chart review of lung and heart/lung-transplant recipients between 1985 and 2008. A total of 32 cases (5%) of PTLD were identified in 639 patients. The median interval after transplantation to the diagnosis was 40 (3-242) months. Eight patients (25%) were diagnosed within one yr of transplantation and had PTLD predominantly within the thorax and allograft. Twenty-four patients (75%) were diagnosed more than one yr after transplantation and their tumors mainly affected the gastrointestinal tract. Monomorphic PTLD, diffuse large B-cell lymphoma, was diagnosed in 91%. Treatment of PTLD varied according to stage and clinical circumstances. Twenty-four patients (75%) have died. The median overall survival was 10 (0-108) months. PTLD after lung transplantation remains a challenge as a result of its frequency, complexity and disappointing outcome.

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