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兔抗胸腺细胞球蛋白与肾移植人群中 PTLD 及其侵袭性形式发展的关系。

Relationship between rabbit anti-thymocyte globulin and development of PTLD and its aggressive form in renal transplant population.

机构信息

Institute of Medical Sciences, Faculty of Medicine, University of Liverpool, Liverpool, UK.

Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Ren Fail. 2020 Nov;42(1):489-494. doi: 10.1080/0886022X.2020.1759636.

Abstract

: The aim of our study is to explore the relationship of rabbit anti-thymocyte globulin (R-ATG) on development of post-transplant lymphoproliferative disease (PTLD) and its aggressive forms (monomorphic PTLD and Hodgkin lymphoma) in renal transplant recipients.: All patients diagnosed with PTLD post-renal transplant in the United States' Organ Procurement and Transplantation Network from 2003 till 2013 and followed up till 2017 were retrospectively reviewed. Multi-variable logistic regression analysis assessed association of R-ATG to development of PTLD and its aggressive form.: Risk of developing PTLD post renal transplant is 1.35%. In comparison to interleukin-2 blocker induction therapy, R-ATG is associated with increased risk of development of PTLD (Odds Ratio = 1.48, confidence interval ranges from 1.04 to 2.11,  = .02) and is associated with higher risk of development of aggressive PTLD (Odds Ratio = 1.83, confidence interval ranges from 1.001 to 3.34,  = .04).: We conclude that R-ATG induction is associated with a higher risk of PTLD and its aggressive form (monomorphic PTLD and Hodgkin lymphoma). Careful monitoring for development of PTLD in renal transplant recipients receiving R-ATG induction therapy is advised.

摘要

: 我们的研究目的是探讨兔抗胸腺细胞球蛋白(R-ATG)与肾移植受者移植后淋巴组织增生性疾病(PTLD)及其侵袭性形式(单形性 PTLD 和霍奇金淋巴瘤)发展之间的关系。

: 回顾性分析了 2003 年至 2013 年期间美国器官获取与移植网络中诊断为肾移植后 PTLD 并随访至 2017 年的所有患者。多变量逻辑回归分析评估了 R-ATG 与 PTLD 及其侵袭性形式发展的相关性。

: 肾移植后发生 PTLD 的风险为 1.35%。与白细胞介素-2 阻滞剂诱导治疗相比,R-ATG 与 PTLD 发展的风险增加相关(优势比=1.48,置信区间范围为 1.04 至 2.11,=0.02),与侵袭性 PTLD 发展的风险增加相关(优势比=1.83,置信区间范围为 1.001 至 3.34,=0.04)。

: 我们得出结论,R-ATG 诱导与 PTLD 及其侵袭性形式(单形性 PTLD 和霍奇金淋巴瘤)的风险增加相关。建议接受 R-ATG 诱导治疗的肾移植受者仔细监测 PTLD 的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b57/7301714/01149ac39da0/IRNF_A_1759636_F0001_C.jpg

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