Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
Am J Hematol. 2011 Feb;86(2):206-9. doi: 10.1002/ajh.21911.
Solid-organ transplant recipients have an elevated risk for some malignancies because of the requirement for immunosuppression [1]. In particular, non-Hodgkin's lymphoma (NHL) is common and comprises one end of a spectrum of post-transplant lymphoproliferative disorder (PTLD) ranging from benign hyperplasia to lymphoid malignancy [2]. PTLD risk is influenced by the type of organ transplanted, the age and Epstein-Barr virus (EBV) serostatus of the transplant recipient, and the intensity of immunosuppression [3-9]. PTLD incidence is high immediately after transplantation, decreases subsequently, and then rises again 4-5 years from transplantation [10,11]. This incidence pattern suggests the presence of separate early-onset and late-onset PTLD subtypes. Early-onset PTLDs tend to be EBV-positive and, when extranodal, are more likely than late-onset PTLDs to be localized to the transplanted organ [12,13]. Late-onset PTLD is less likely to be associated with EBV and, overall, is more likely than early-onset PTLD to be extranodal [13,14]. The Scientific Registry of Transplant Recipients (SRTR) includes data on a large number of solid-organ transplant recipients in the United States and information on malignancies diagnosed post-transplantation. We used these data to conduct a retrospective cohort study among kidney transplant recipients to examine differences in risk factors between early-onset PTLD and late-onset PTLD.
实体器官移植受者由于需要免疫抑制而存在某些恶性肿瘤的风险增加[1]。特别是，非霍奇金淋巴瘤（NHL）很常见，并且构成移植后淋巴组织增生性疾病（PTLD）谱的一端，从良性增生到淋巴恶性肿瘤[2]。PTLD 的风险受移植器官的类型、移植受者的年龄和 Epstein-Barr 病毒（EBV）血清状态以及免疫抑制的强度的影响[3-9]。PTLD 的发病率在移植后立即很高，随后降低，然后在移植后 4-5 年再次升高[10,11]。这种发病模式表明存在单独的早发和晚发 PTLD 亚型。早发 PTLD 往往是 EBV 阳性的，当发生于结外时，比晚发 PTLD 更可能局限于移植器官[12,13]。晚发 PTLD 不太可能与 EBV 相关，并且总体上比早发 PTLD 更可能发生于结外[13,14]。移植受者科学登记处（SRTR）包括美国大量实体器官移植受者的数据以及移植后诊断出的恶性肿瘤信息。我们使用这些数据对肾移植受者进行了回顾性队列研究，以检查早发和晚发 PTLD 之间的危险因素差异。
