Saadat A, Einollahi B, Ahmadzad-Asl M A, Moradi M, Nafar M, Pourfarziani V, Firoozan A, Porrezagholi F, Davoudi F
Department of Internal Medicine, Baqyiatollah University of Medical Sciences, Tehran, Iran.
Transplant Proc. 2007 May;39(4):1071-3. doi: 10.1016/j.transproceed.2007.03.052.
Despite the benefits of immunosuppressive medications to improve graft function, they have several adverse effects, such as development of neoplasms in renal transplant recipients. Posttransplantation lymphoproliferative disorders (PTLDs) are not uncommon complications, so we conducted a study to evaluate the characteristics of affected patients.
We enrolled 2117 kidney recipients from June 1984 to March 2004 in order to find pathological and clinical evidence of neoplasms. We collected and analyzed all data on PTLD patients.
Overall there were 46 recipients with different types of neoplasms, among which the most common types were diseases of the skin (24 cases, 52.2%), Kaposi's sarcoma (15 cases, 32.6%), and PTLD (14 cases, 30.4%). The mean (+/- SD) age of PTLD patients at the time of transplantation was 37.86 +/- 9.67 years and 42.8% were women. Median and mean (+/- SD) time interval to PTLD diagnosis were 38.5 and 50.35 +/- 41.7 months, respectively (range 1 to 146 months). Types of PTLD in these patients were kidney lymphoma (14.3%); gastrointestinal (14.3%); brain lymphoma; tonsils; palatine; Hodgkin's lymphoma, large cell lymphoma, and acute lymphoblastic lymphoma (each 7.1%), with 28.6% unspecified types. The 1-, 5-, and 10-year patient survival rates after transplantation were 71.4%, 51.4%, and 44.3%, respectively. Despite discontinuing immunosuppressive therapy in PTLD patients, five of six surviving had graft function up to a mean time of 105.4 +/- 57.6 months after transplantation.
Our findings showed that the prevalence of PTLD was 0.66%, which was less than reports from Western countries. The fact that there were surviving grafts for a considerable time despite discontinuing immunosuppressive therapy is of great importance.
尽管免疫抑制药物有助于改善移植物功能，但它们有一些不良反应，比如肾移植受者会发生肿瘤。移植后淋巴细胞增殖性疾病（PTLD）是常见的并发症，因此我们开展了一项研究来评估受累患者的特征。
为了找到肿瘤的病理和临床证据，我们纳入了1984年6月至2004年3月期间的2117名肾移植受者。我们收集并分析了所有PTLD患者的数据。
总体上有46名受者患有不同类型的肿瘤，其中最常见的类型是皮肤疾病（24例，52.2%）、卡波西肉瘤（15例，32.6%）和PTLD（14例，30.4%）。PTLD患者移植时的平均（±标准差）年龄为37.86±9.67岁，42.8%为女性。PTLD诊断的中位时间和平均（±标准差）时间间隔分别为38.5个月和50.35±41.7个月（范围1至146个月）。这些患者的PTLD类型包括肾淋巴瘤（14.3%）；胃肠道（14.3%）；脑淋巴瘤；扁桃体；腭部；霍奇金淋巴瘤、大细胞淋巴瘤和急性淋巴细胞白血病（各7.1%），28.6%为未明确类型。移植后1年、5年和10年的患者生存率分别为71.4%、51.4%和44.3%。尽管对PTLD患者停用了免疫抑制治疗，但6名存活患者中有5名在移植后的平均105.4±57.6个月内仍保持移植物功能。
我们的研究结果表明，PTLD的患病率为0.66%，低于西方国家的报道。尽管停用了免疫抑制治疗，但移植物仍存活相当长一段时间，这一事实非常重要。
