Single-center analysis of biopsy-confirmed posttransplant lymphoproliferative disorder: incidence, clinicopathological characteristics and prognostic factors

Abstract

Hematopoietic stem cell and solid organ transplant recipients diagnosed with biopsy-confirmed posttransplant lymphoproliferative disorder (PTLD) at our institution from 1989 to 2010 were identified. Patient-, transplant- and disease-related characteristics, prognostic factors and outcome were collected and analyzed. One hundred and forty biopsy-proven cases of PTLD were included. Overall incidence in the transplant population was 2.12%, with heart transplant recipients carrying the highest risk. Most PTLDs were monomorphic (82%), with diffuse large B-cell lymphoma being the most frequent subtype. The majority of cases (70.7%) occurred > 1 year posttransplant, and 66% were Epstein–Barr virus positive. Following initial therapy the overall response rate was 68.5%. Three-year relapse-free and overall survivals were 59% and 49%, respectively. At last follow-up, 44% of the patients were alive. Multivariable analysis identified several classical lymphoma-specific poor prognostic factors for the different outcome measures. The value of the International Prognostic Index was confirmed in our analysis.

Keywords::

• Immunosuppression
• posttransplant lymphoproliferative disorder
• PTLD
• transplant

Acknowledgements

We would like to thank Mrs Emilie Bittoun for technical assistance, Mr Albert Herelixka for his efforts in preparing the figures and tables and Mrs An Herreman for her invaluable assistance in collecting and scoring the tissue biopsies.

Potential conflict of interest:

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.

This work was supported by the K. U. Leuven (grant GOA/11/010 to I.W.) and by the FWO-Vlaanderen (GO81411N to Gr.V. and T.T.). Gr.V. is holder of the International Roche Chair in Hematology.