Identification of high-risk monomorphic post-transplant lymphoproliferative disorder following solid organ transplantation

Abstract

Monomorphic post-transplant lymphoproliferative disorder (M-PTLD) occurring after solid organ transplant histologically resembles aggressive non-Hodgkin lymphomas, with diffuse large B-cell lymphoma being the most common. In a cohort of 40 patients with DLBCL-type M-PTLD, inferior progression free survival (PFS) was observed for Revised International Prognostic Index (R-IPI) >2 (p = 0.01) and high-risk pathologic features (p = 0.02), defined by double expressor lymphoma, MYC rearrangement, or increased copy number of either MYC or BCL2. Overall survival (OS) was inferior in R-IPI >2 (p = 0.002) and high-risk pathologic features (p = 0.003). Combining both R-IPI >2 and high-risk pathologic features resulted in well-delineated good, intermediate, and poor risk groups of DLBCL-type M-PTLD with respect to both PFS and OS (p < 0.001). Our results demonstrate a prognostic role for both the R-IPI score and presence of high-risk pathologic features in DLBCL-type M-PTLD.

Keywords:

• Post-transplant lymphoproliferative disorder
• PTLD
• monomorphic
• outcome
• survival

Acknowledgments

The authors thank the North Carolina Translational and Clinical Sciences Institute for supporting the i2b2 software used in conducting this study, supported by the National Center for Advancing Translational Sciences and National Institutes of Health, through Grant Award Number UL1TR002489.

Disclosure statement

The authors have no conflict of interest.