Swerdlow Steven H
Department of Pathology, Division of Hematopathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Am J Clin Pathol. 2007 Jun;127(6):887-95. doi: 10.1309/LYXN3RGF7D7KPYG0.
Posttransplantation lymphoproliferative disorders (PTLDs) of T-cell or natural killer (NK)-cell origin are an uncommon heterogeneous group of lymphoid proliferations that fulfill the criteria for one of the T- or NK-cell lymphomas/leukemias. This report summarizes 130 T/NK-cell PTLDs reported in the literature or presented at the Society for Hematopathology/European Association for Haematopathology Workshop on T/NK-cell malignancies. The T/NK-cell PTLDs occur at a median of 66 months following transplantation and are usually extranodal. The most common types reported are peripheral T-cell lymphoma, unspecified, and hepatosplenic T-cell lymphoma. Approximately one third are Epstein-Barr virus (EBV)+. The median survival is 6 months. EBV+ cases have a significantly longer survival than EBV- cases, even when indolent T-cell large granular lymphocytic leukemias are included among the EBV- cases. Many T/NK-cell PTLDs have been treated with chemotherapy, often together with decreased immunosuppression, but there are infrequent patients who have done well without chemotherapy or radiation.
T细胞或自然杀伤（NK）细胞起源的移植后淋巴组织增生性疾病（PTLD）是一组罕见的异质性淋巴样增生性疾病，符合T细胞或NK细胞淋巴瘤/白血病的诊断标准。本报告总结了文献报道或在血液病理学学会/欧洲血液病理学协会T/NK细胞恶性肿瘤研讨会上展示的130例T/NK细胞PTLD。T/NK细胞PTLD通常发生在移植后66个月，且多为结外病变。报告中最常见的类型是外周T细胞淋巴瘤，未另行特指型，以及肝脾T细胞淋巴瘤。约三分之一的病例为EB病毒（EBV）阳性。中位生存期为6个月。即使将惰性T细胞大颗粒淋巴细胞白血病纳入EBV阴性病例中，EBV阳性病例的生存期仍显著长于EBV阴性病例。许多T/NK细胞PTLD接受了化疗，通常同时减少免疫抑制，但也有少数患者未经化疗或放疗却预后良好。
