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Just Accepted by Leukemia & Lymphoma
Single-center analysis of biopsy-confirmed
posttransplant lymphoproliferative disorder:
incidence, clinico-pathological characteristics and
prognostic factors
Daan Dierickx, Thomas Tousseyn , Xavier Sagaert, Steffen Fieuws,
Iwona Wlodarska, Julie Morscio, Lieselot Brepoels, Dirk Kuypers,
Johan Vanhaecke, Frederik Nevens, Geert Verleden,
Rita Van Damme-Lombaerts, Marleen Renard, Jacques Pirenne,
Christiane De Wolf-Peeters and Gregor Verhoef
doi:10.3109/10428194.2013.780655
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-, transplantation- and disease-related characteristics,
prognostic factors and outcome were collected and analyzed. One
hundred-forty biopsy-proven PTLD cases were included. Overall
incidence in the transplant population was 2.12% with heart
transplant recipients carrying the highest risk. Most PTLDs were
monomorphic (83.6%) with diffuse large B cell lymphoma being the
most frequent subtype. The majority of cases (70.7%) occurred > 1
year posttransplantation, whereas 66% were Epstein Barr virus
positive. Following initial therapy overall response rate was 68.5%.
Three-year relapse-free and overall survival 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.
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