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

• Published in: Clinical transplantation Vol. 26; no. 5; pp. 679 - 683
• Main Authors: Chan, Thomas S.Y., Hwang, Yu-Yan, Gill, Harinder, Au, Wing-Yan, Leung, Anskar Y.H., Tse, Eric, Chim, Chor-Sang, Loong, Florence, Kwong, Yok-Lam
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.2012; Wiley
• Subjects: Adult; Age; Aged; Antibodies; Asia; B-cell lymphoma; Biological and medical sciences; Chemotherapy; China; Drug Therapy, Combination; Epstein-Barr virus; Epstein-Barr Virus Infections - drug therapy; Epstein-Barr Virus Infections - mortality; Epstein-Barr Virus Infections - virology; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Gills; Hematologic and hematopoietic diseases; Herpesvirus 4, Human - pathogenicity; Hodgkin's disease; Humans; Immunoproliferative diseases; Immunosuppression; Immunosuppressive Agents - therapeutic use; L-Lactate dehydrogenase; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell - complications; Lymphoma, B-Cell - mortality; Lymphoma, B-Cell - surgery; Lymphomatoid papulosis; Lymphoproliferative Disorders - drug therapy; Lymphoproliferative Disorders - etiology; Lymphoproliferative Disorders - mortality; Male; Medical sciences; Middle Aged; Natural killer cells; Organ Transplantation - adverse effects; Organ Transplantation - mortality; post-transplant lymphoproliferative disorders; Postoperative Complications; posttransplant lymphoproliferative disorders; Prognosis; Remission; Remission Induction; Retrospective Studies; rituximab; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Rate; Tissue, organ and graft immunology; Asia; China; Late; Asiatic; Solid organ; Hemopathy; Transplantation; Homotransplantation; Medicine; Response; Treatment; post-transplant lymphoproliferative disorders; Age of onset; Posttransplant lymphoproliferative disorder; Asia; Surgery; Lymphoproliferative syndrome; Graft
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2011.01593.x

Chan TSY, Hwang Y‐Y, Gill H, Au W‐Y, Leung AYH, Tse E, Chim C‐S, Loong F, Kwong Y‐L. Post‐transplant lymphoproliferative diseases in Asian solid organ transplant recipients: late onset and favorable response to treatment. :  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.