Department of Nephrology Transplantation, Strasbourg University Hospital, France Service of Molecular Biochemistry, Strasbourg University Hospital, France.
Am J Transplant. 2011 Jun;11(6):1260-9. doi: 10.1111/j.1600-6143.2011.03544.x. Epub 2011 May 12.
Although in previous studies most post-transplant lymphoproliferative disorders (PTLD) were reported to derive from recipient cells, some cases derived from donor lymphocytes have been reported. To provide a better description of the features and outcome of PTLD according to the origin of the lymphoma, we performed histologic and molecular studies of PTLD in kidney recipients. Forty-three specimens were analyzed by histochemistry, fluorescent hybridization of the Y chromosome and analysis of multiple short tandem repeat microsatellite loci. Sixteen tumors were shown to be of donor origin and 27 of recipient origin. Time to PTLD was shorter in donor-derived PTLDs (20 ± 27 vs. 69 ± 67 months, p = 0.013). Ten-year patient survival was similar among patients with recipient- and donor-derived PTLD, but when PTLD-related mortality was analyzed, there was a trend to better survival in patients with donor lymphomas. Among the 21 PTLDs localized in the allograft, 14 lymphomas were of donor origin and seven of recipient origin. No difference was found between the two groups. Our analysis of the origin of PTLDs in the largest cohort studied to date with a description of the clinical and histological characteristics of donor and recipient PTLDs should lead to a better understanding of lymphomagenesis.
虽然在以前的研究中，大多数移植后淋巴组织增生性疾病（PTLD）被认为来源于受者细胞，但也有一些来源于供者淋巴细胞的病例报道。为了更好地描述根据淋巴瘤起源的 PTLD 的特征和结局，我们对肾移植受者的 PTLD 进行了组织学和分子研究。通过组织化学、Y 染色体荧光杂交和多个短串联重复微卫星位点分析，对 43 个标本进行了分析。结果显示，16 个肿瘤来源于供者，27 个来源于受者。供者来源的 PTLD 发生时间更短（20±27 个月 vs. 69±67 个月，p=0.013）。受体和供体来源的 PTLD 患者的 10 年生存率相似，但分析与 PTLD 相关的死亡率时，供体来源的淋巴瘤患者的生存率有更好的趋势。在 21 例移植肾局部的 PTLD 中，14 例来源于供者，7 例来源于受者。两组之间没有差异。我们对迄今为止研究中最大队列中 PTLD 起源的分析，以及对供体和受体 PTLD 的临床和组织学特征的描述，应该有助于更好地理解淋巴瘤的发生机制。
