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

Clin Transplant. 2012 Sep-Oct;26(5):679-83. doi: 10.1111/j.1399-0012.2011.01593.x. Epub 2012 Feb 10.

Abstract

Nineteen consecutive patients with post-transplant lymphoproliferative disorders (PTLD) in an Asian population were reviewed. The histopathologic diagnoses were monomorphic (CD20-positive diffuse large B-cell lymphoma, n = 14); plasmacytic (n = 1); Burkitt-like (n = 1); natural killer cell lymphoma (n = 1); lymphomatoid papulosis (n = 1); and classical Hodgkin lymphoma (n = 1). Early-onset (<one yr post-transplantation) PTLD constituted only 10% of cases, and all were Epstein-Barr virus (EBV) positive. EBV-negative cases (n = 6) developed at a median of 92 (19-170) months, whereas EBV-positive cases occurred later at 128 (7-230) months. With reduction of immunosuppression followed by local therapy, treatment with the anti-CD20 antibody rituximab with or without combination chemotherapy, complete remission was achieved in 17/19 (90%) of cases. Lactate dehydrogenase level, stage, extranodal involvement, EBV status, and International Prognostic Index had no impact on treatment outcome. EBV-positive PTLD occurred much later in Asian patients. Treatment results of PTLD were favorable.

MeSH terms

  • Adult
  • Aged
  • China
  • Drug Therapy, Combination
  • Epstein-Barr Virus Infections / drug therapy
  • Epstein-Barr Virus Infections / mortality
  • Epstein-Barr Virus Infections / virology
  • Female
  • Follow-Up Studies
  • Herpesvirus 4, Human / pathogenicity
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Lymphoma, B-Cell / complications*
  • Lymphoma, B-Cell / mortality
  • Lymphoma, B-Cell / surgery
  • Lymphoproliferative Disorders / drug therapy
  • Lymphoproliferative Disorders / etiology*
  • Lymphoproliferative Disorders / mortality
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • Organ Transplantation / mortality
  • Postoperative Complications*
  • Prognosis
  • Remission Induction
  • Retrospective Studies
  • Survival Rate

Substances

  • Immunosuppressive Agents