Very late onset lymphoproliferative disorders occurring over 10 years post-renal transplantation: PTLD.Int. Survey.

BACKGROUND AND OBJECTIVES

Knowledge of the significance of post-transplant lymphoproliferative disorders (PTLD) that occur "very late" or more 10 years after renal transplantation is limited. thus, we analysed and compared characteristics and prognosis of the disease in renal transplant patients with very late onset PTLD vs. early- and late-onset PTLD.

DESIGN AND SETTING

Retrospective study of data obtained from comprehensive search of medical literature

PATIENTS AND METHODS

We searched for available data using the Pubmed and Google scholar search engines for reports of lymphoproliferative disorders occurring in renal transplant patients by disease presentation time.

RESULTS

We analyzed data from 27 studies that included 303 patients with lymphoproliferative disorders after renal transplantation. Renal graft recipients with very late onset PTLD were significantly less likely to be under mycophenolate mofetil (MMF)- and/or tacrolimus (FK-506) (vs. azathioprine) -based immunosuppression (P=.035) and less likely to have a history of antibody induction immunosuppression (P<.001). Compared to "early onset" disease, "very late" onset PTLD is more likely to develop in older patients (P=.032). Survival analysis did not show any difference in outcome (P=.5). no organ involvement priority was found for this patient group (P>.1 for all).

CONCLUSIONS

Older renal transplant patients are at increased risk for development of very late onset PTLD, and should be strictly followed. further multi-institutional prospective studies are needed to confirm our results.