a Hematology Department , Hospital Universitario y Politécnico La Fe , Valencia , Spain.
b CIBERONC (Centro de Investigación Biomédica en Red de Cáncer), Instituto Carlos III , Madrid , Spain.
Leuk Lymphoma. 2019 Jan;60(1):142-150. doi: 10.1080/10428194.2018.1474462. Epub 2018 Jul 3.
Post-transplant lymphoproliferative disorders (PTLD) are a rare complication after both solid organ (SOT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this single center retrospective study, we compared clinical, biological, and histological features, and outcomes of PTLD after both types of transplant. We identified 82 PTLD (61 after SOT and 21 after allo-HSCT). The presence of B symptoms, Waldeyer ring, spleen, central nervous system, and liver involvement, and advanced Ann-Arbor stage were more frequent in allo-HSCT recipients. PTLD had an earlier onset in allo-HSCT than in SOT cohort (4 vs. 64 months, p < .0001). PTLD was EBV-positive in 100% of allo-HSCT, in contrast to 47% of SOT (p = .0002). Four years after PTLD diagnosis, median overall survival was 32% (95% CI, 22-48) and 10% (95% CI, 2-49) in SOT and allo-HSCT recipients, respectively (p = .002). In conclusion, the clinical presentation and the outcome of PTLD varies greatly depending on the type of transplant.
移植后淋巴增殖性疾病（PTLD）是实体器官（SOT）和异基因造血干细胞移植（allo-HSCT）后罕见的并发症。在这项单中心回顾性研究中，我们比较了两种移植后 PTLD 的临床、生物学和组织学特征及结局。我们共确定了 82 例 PTLD（61 例 SOT 后，21 例 allo-HSCT 后）。allo-HSCT 受者更常出现 B 症状、Waldeyer 环、脾脏、中枢神经系统和肝脏受累以及晚期 Ann-Arbor 分期。allo-HSCT 比 SOT 更早出现 PTLD（4 个月 vs. 64 个月，p<0.0001）。allo-HSCT 中 100%的 PTLD 为 EBV 阳性，而 SOT 中为 47%（p=0.0002）。PTLD 诊断后 4 年，SOT 和 allo-HSCT 受者的总生存中位数分别为 32%（95%CI，22-48）和 10%（95%CI，2-49）（p=0.002）。总之，PTLD 的临床表现和结局因移植类型而异。
