Post-transplantation lymphoproliferative disorder in living-donor liver transplantation: a single-center experience

Nakanishi, Chikashi; Kawagishi, Naoki; Sekiguchi, Satoshi; Akamatsu, Yorihiro; Sato, Kimitaka; Miyagi, Shigehito; Takeda, Ikuo; Fukushima, Daizo; Kobayashi, Yoshinobu; Ishida, Kazuyuki; Niizuma, Hidetaka; Tsuchiya, Shigeru; Wada, Mitsuru; Nio, Masaki; Satoh, Susumu

doi:10.1007/s00595-012-0127-7

Cited by 7 publications

(7 citation statements)

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“…In contrast, PTLD incidence is about 4% after hematopoietic stem cell transplant (HSCT) [ 9 ]. Historically, mortality rates in SOT-related PTLD were 50–70% and up to 70–90% in HSCT, although recent data suggests that outcomes have been improving and comparable to SOT [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Post-transplant lymphoproliferative disorder (PTLD): single institutional experience of 141 patients

et al. 2017

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BackgroundPost-transplant lymphoproliferative disorder is a well-recognized but rare complication of hematopoietic stem cell and solid organ transplant. Due to rarity of this disease, retrospective studies from major transplant centers has been the main source to provide treatment guidelines, which are still in evolution. The sample size of this study is among one of the largest study on PTLD till date reported throughout the world.MethodsThis study was performed at University of Florida which is one of the largest transplant center in South East United States. We performed treatment and survival analysis along with univariate and multivariate analysis to identify prognostic factors.ResultsWe reviewed 141 patients diagnosed with PTLD over last 22 years with median follow-up of 2.4 years. The estimated median overall survival of the entire group was 15.0 years. Sub group analysis showed that 5-year overall survival rates of pediatric population were 88% (median not reached). For adults, median OS was 5.35 years while for elderly patients it was 1.32 years. The estimated median OS of patients with monomorphic PTLD was 9.0 years while in polymorphic PTLD was 19.3 years. Univariate analysis identified gender, age at transplant and PTLD diagnosis, performance status, IPI score, allograft type, recipient EBV status, multiple acute rejections prior to PTLD diagnosis, PTLD sub-type, extra-nodal site involvement, immunosuppressive drug regimen at diagnosis, initial treatment best response were statistically significant prognostic factors (p < 0.05). On multivariate analysis, age at PTLD diagnosis, recipient EBV status, bone marrow involvement, and initial best response were statistically significant prognostic factors (p < 0.05). Surprisingly, use of Rituximab alone as upfront therapy had poor hazard ratio in the cumulative group as well less aggressive PTLD subgroup comprising of early lesions and polymorphic PTLD.ConclusionsOur experience with treatment and analysis of outcomes does challenge current role of Rituximab use in treatment of PTLD. Currently as we define role of immunotherapy in cancer treatment, the role of acute rejections and immunosuppressant in PTLD becomes more relevant as noticed in our study. This study was also able to find new prognostic factors and also verified other known prognostic factors.

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Section: Introductionmentioning

confidence: 99%

Post-transplant lymphoproliferative disorder (PTLD): single institutional experience of 141 patients

et al. 2017

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“…2 Recently, a few comprehensive studies on the characteristics of PTLD have been reported in the Asian population, including research completed by our institution. [3][4][5][6] Unfortunately, to our knowledge, there are no large systemic reviews of the correlation between PTLD and whole blood EBV DNA levels in Korean organ recipients.…”

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confidence: 99%

Pattern Analysis of Epstein-Barr Virus Viremia and Its Significance in the Evaluation of Organ Transplant Patients Suspected of Having Posttransplant Lymphoproliferative Disorders

Cho

Chi

Jang

et al. 2014

American Journal of Clinical Pathology

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“…However, these risk factors may reflect center effects. 5 Treatment for recurrent acute rejection also puts patients at risk for PTLD. The risk of symptomatic EBV infection and PTLD is greater in patients with more than 1 rejection episode in the first year after transplant.…”

Section: Pathologymentioning

confidence: 99%

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Özçay

2017

Exp Clin Transplant

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Post-transplantation lymphoproliferative disorder in living-donor liver transplantation: a single-center experience

Abstract: Although PTLD is potentially life-threatening, it can be managed by appropriate and prompt treatment, with a good outcome.

Cited by 7 publications

References 53 publications

Post-transplant lymphoproliferative disorder (PTLD): single institutional experience of 141 patients

Post-transplant lymphoproliferative disorder (PTLD): single institutional experience of 141 patients

Pattern Analysis of Epstein-Barr Virus Viremia and Its Significance in the Evaluation of Organ Transplant Patients Suspected of Having Posttransplant Lymphoproliferative Disorders

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