Research Article
Solid Organ Transplantasyonu Sonrası Post-Transplant Lenfoproliferatif Hastalıklar: Tek Merkez Deneyimi
Abstract
Amaç: Kliniğimizde solid organ transplantasyonu sonrası post-transplant lenfoproliferatif hastalık tanısı almış hastaların klinik bulgularını, laboratuar özelliklerini, genel ve progesyonsuz sağ kalımlarını değerlendirmeyi amaçladık.
Yöntemler: Ocak 2000- Aralık 2018 yılları arasında solid organ transplantasynu sonrası post-transplant lenfoproliferatif hastalık tanısı alan hastalar retrospektif olarak incelendi. Hastaların cinsiyeti, transplantasyon oldukları yaş, lenfoproliferatif hastalık tanı yaşı, transplantasyon sonrası lenfoproliferatif hastalık tanısına kadar geçen süre, lenfoproliferatif hastalık için klinik prezentasyonları, tümör karakteristikleri, tanı anındaki laktat dehidrogenaz düzeyleri, immunsupresif tedavileri, lenfoproliferatif hastalık için aldıkları tedaviler ve bu tedavilere yanıtları, toplam ve olaysız sağ kalım değerlendirildi.
Bulgular: On hastaya post-transplant lenfoproliferatif hastalık tanısı konmuştur. Hastaların 8’i böbrek, 2’si karaciğer transplantasyonu sonrası lenfoproliferatif hastalık tanısı almışlardır. 8 hastaya diffüz büyük B hücreli lenfoma, 2 hastaya toplam 3 kere Hodgkin lenfoma (1 hasta nüks etmiştir) tanısı konmuştur. 5 yıllık sağ kalım %90±9 ve olaysız sağ kalım 150,76±13,28 ay bulunmuştur.
Sonuç: Erken dönemde septik nedenlerle kaybedilen bir hasta dışındaki hastalar hayatta ve remisyondadır. Çalışmamızın 5 yıllık sağ kalım oranının literatürde bildirilen birçok çalışmadan daha uzun olması tedavi başarısını göstermektedir.
References
- 1. Adami J, Gäbel H, Lindelöf B, et al. Cancer risk following organ transplantation: a nationwide cohort study in Sweden. Br J Cancer 2003; 89: 1221. 2. Petrara MR, Giunco S, Serraino D, Dolcetti R, De Rossi A. Post-transplant lymphoproliferative disorders: from epidemiology to pathogenesis-driven treatment. Cancer Lett 2015; 369: 37-44. 3. Ibrahim HA, Naresh KN. Posttransplant lymphoproliferative disorders. Adv Hematol 2012; 2012: 230173. 4. Opelz G, Naujokat C, Daniel V, Terness P, Döhler B. Disassociation between risk of graft loss and risk of non-Hodgkin lymphoma with induction agents in renal transplant recipients. Transplantation 2006; 81: 1227. 5. Shahinian VB, Muirhead N, Jevnikar AM, et al. Epstein-Barr virus seronegativity is a risk factor for late-onset posttransplant lymphoroliferative disorder in adult renal allograft recipients. Transplantation 2003; 75: 851. 6. Zangwill SD, Hsu DT, Kichuk MR, et all. Incidence and outcome of primary Epstein-Barr virus infection and lymphoproliferative disease in pediatric heart transplant recipients. J Heart Lung Transplant 1998; 17: 1161. 7. Swerdlow SH, Campo E, Harris NL, et al. (Eds): WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition). lARC: Lyon 2017, p.453- 462. 8. Tsai DE, Hardy CL, Tomaszewski JE, et al. Reduction in immunosuppression as initial therapy for posttransplant lymphoproliferative disorder: analysis of prognostic variables and long-term follow-up of 42 adult patients. Transplantation 2001; 71: 1076. 9. Trappe R, Oertel S, Leblond V, et al. Sequential treatment with rituximab followed by CHOP chemotherapy in adult B-cell post-transplant lymphoproliferative disorder (PTLD): the prospective international multicentre phase 2 PTLD-1 trial. Lancet Oncol 2012; 13: 196-206. 10. Jagadeesh D, Woda BA, Draper J, Evens AM. Post transplant lymphoproliferative disorders: risk, classification, and therapeutic recommendations. Curr Treat Options Oncol 2012; 13: 122. 11. Evens AM, David KA, Helenowski I, et al. Multicenter analysis of 80 solid organ transplantation recipients with post-transplantation lymphoproliferative disease: outcomes and prognostic factors in the modern era. J Clin Oncol 2010; 20; 28: 1038-46. 12. Dierickx D, Tousseyn T, Sagaert X, et al. Single-center analysis of biopsy-confirmed posttransplant lymphoproliferative disorder: incidence, clinicopathological characteristics and prognostic factors. Leuk Lymphoma 2013; 54: 2433-40. 13. Kinch A, Baecklund E, Backlin C, et al. A population-based study of 135 lymphomas after solid organ transplantation: The role of Epstein-Barr virus, hepatitis C and diffuse large B-cell lymphoma subtype in clinical presentation and survival. Acta Oncol 2014; 53: 669-79. 14. Ready E, Chernushkin K, Partovi N, et al. Posttransplant Lymphoproliferative Disorder in Adults Receiving Kidney Transplantation in British Columbia: A Retrospective Cohort Analysis. Can J Kidney Health Dis 2018; 1: 5: 1–12. 15. Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: The Lugano classification. J Clin Oncol 2014; 32: 3059-67. 16. Morton M, Coupes B, Roberts SA, et al. Epidemiology of posttransplantation lymphoproliferative disorder in adult renal transplant recipients. Transplantation 2013; 15: 95: 470-8. 17. Ishihara H, Shimizu T, Unagami K, et al. Post-Transplant Lymphoproliferative Disorder in Kidney Transplant Recipients: A Single-Center Experience in Japan. Ther Apher Dial 2016; 20: 165-73. 18. Caillard S, Lelong C, Pessione F, Moulin B; French PTLD Working Group. Post-transplant lymphoproliferative disorders occurring after renal transplantation in adults: report of 230 cases from the French Registry. Am J Transplant 2006; 6: 2735-42. 19. Trofe J, Buell JF, Beebe TM, et al. Analysis of factors that influence survival with post-transplant lymphoproliferative disorder in renal transplant recipients: the Israel Penn International Transplant Tumor Registry experience. Am J Transplant 2005; 5: 775–80. 20. Cavaliere R, Petroni G, Lopes MB, Schiff D; International Primary Central Nervous System Lymphoma Collaborative Group. Primary central nervous system post-transplantation lymphoproliferative disorder: an International Primary Central Nervous System Lymphoma Collaborative Group Report. Cancer 2010; 15: 116: 863-70. 21. Dierickx D, Tousseyn T, Sagaert X, et al. Single-center analysis of biopsy-confirmed posttransplant lymphoproliferative disorder: incidence, clinicopathological characteristics and prognostic factors. Leuk Lymphoma 2013; 54: 2433-40. 22. Trappe R, Oertel S, Leblond V, et al. Sequential treatment with rituximab followed by CHOP chemotherapy in adult B-cell post-transplant lymphoproliferative disorder (PTLD): the prospective international multicentre phase 2 PTLD-1 trial. Lancet Oncol 2012; 13: 196-206. 23. Jain A, Nalesnik M, Reyes J, et al. Posttransplant lymphoproliferative disorders in liver transplantation: a 20-year experience. Ann Surg 2002; 236: 429-37.
Year 2019,
Volume: 46 Issue: 4, 743 - 749, 15.12.2019
Abstract
References
- 1. Adami J, Gäbel H, Lindelöf B, et al. Cancer risk following organ transplantation: a nationwide cohort study in Sweden. Br J Cancer 2003; 89: 1221. 2. Petrara MR, Giunco S, Serraino D, Dolcetti R, De Rossi A. Post-transplant lymphoproliferative disorders: from epidemiology to pathogenesis-driven treatment. Cancer Lett 2015; 369: 37-44. 3. Ibrahim HA, Naresh KN. Posttransplant lymphoproliferative disorders. Adv Hematol 2012; 2012: 230173. 4. Opelz G, Naujokat C, Daniel V, Terness P, Döhler B. Disassociation between risk of graft loss and risk of non-Hodgkin lymphoma with induction agents in renal transplant recipients. Transplantation 2006; 81: 1227. 5. Shahinian VB, Muirhead N, Jevnikar AM, et al. Epstein-Barr virus seronegativity is a risk factor for late-onset posttransplant lymphoroliferative disorder in adult renal allograft recipients. Transplantation 2003; 75: 851. 6. Zangwill SD, Hsu DT, Kichuk MR, et all. Incidence and outcome of primary Epstein-Barr virus infection and lymphoproliferative disease in pediatric heart transplant recipients. J Heart Lung Transplant 1998; 17: 1161. 7. Swerdlow SH, Campo E, Harris NL, et al. (Eds): WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition). lARC: Lyon 2017, p.453- 462. 8. Tsai DE, Hardy CL, Tomaszewski JE, et al. Reduction in immunosuppression as initial therapy for posttransplant lymphoproliferative disorder: analysis of prognostic variables and long-term follow-up of 42 adult patients. Transplantation 2001; 71: 1076. 9. Trappe R, Oertel S, Leblond V, et al. Sequential treatment with rituximab followed by CHOP chemotherapy in adult B-cell post-transplant lymphoproliferative disorder (PTLD): the prospective international multicentre phase 2 PTLD-1 trial. Lancet Oncol 2012; 13: 196-206. 10. Jagadeesh D, Woda BA, Draper J, Evens AM. Post transplant lymphoproliferative disorders: risk, classification, and therapeutic recommendations. Curr Treat Options Oncol 2012; 13: 122. 11. Evens AM, David KA, Helenowski I, et al. Multicenter analysis of 80 solid organ transplantation recipients with post-transplantation lymphoproliferative disease: outcomes and prognostic factors in the modern era. J Clin Oncol 2010; 20; 28: 1038-46. 12. Dierickx D, Tousseyn T, Sagaert X, et al. Single-center analysis of biopsy-confirmed posttransplant lymphoproliferative disorder: incidence, clinicopathological characteristics and prognostic factors. Leuk Lymphoma 2013; 54: 2433-40. 13. Kinch A, Baecklund E, Backlin C, et al. A population-based study of 135 lymphomas after solid organ transplantation: The role of Epstein-Barr virus, hepatitis C and diffuse large B-cell lymphoma subtype in clinical presentation and survival. Acta Oncol 2014; 53: 669-79. 14. Ready E, Chernushkin K, Partovi N, et al. Posttransplant Lymphoproliferative Disorder in Adults Receiving Kidney Transplantation in British Columbia: A Retrospective Cohort Analysis. Can J Kidney Health Dis 2018; 1: 5: 1–12. 15. Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: The Lugano classification. J Clin Oncol 2014; 32: 3059-67. 16. Morton M, Coupes B, Roberts SA, et al. Epidemiology of posttransplantation lymphoproliferative disorder in adult renal transplant recipients. Transplantation 2013; 15: 95: 470-8. 17. Ishihara H, Shimizu T, Unagami K, et al. Post-Transplant Lymphoproliferative Disorder in Kidney Transplant Recipients: A Single-Center Experience in Japan. Ther Apher Dial 2016; 20: 165-73. 18. Caillard S, Lelong C, Pessione F, Moulin B; French PTLD Working Group. Post-transplant lymphoproliferative disorders occurring after renal transplantation in adults: report of 230 cases from the French Registry. Am J Transplant 2006; 6: 2735-42. 19. Trofe J, Buell JF, Beebe TM, et al. Analysis of factors that influence survival with post-transplant lymphoproliferative disorder in renal transplant recipients: the Israel Penn International Transplant Tumor Registry experience. Am J Transplant 2005; 5: 775–80. 20. Cavaliere R, Petroni G, Lopes MB, Schiff D; International Primary Central Nervous System Lymphoma Collaborative Group. Primary central nervous system post-transplantation lymphoproliferative disorder: an International Primary Central Nervous System Lymphoma Collaborative Group Report. Cancer 2010; 15: 116: 863-70. 21. Dierickx D, Tousseyn T, Sagaert X, et al. Single-center analysis of biopsy-confirmed posttransplant lymphoproliferative disorder: incidence, clinicopathological characteristics and prognostic factors. Leuk Lymphoma 2013; 54: 2433-40. 22. Trappe R, Oertel S, Leblond V, et al. Sequential treatment with rituximab followed by CHOP chemotherapy in adult B-cell post-transplant lymphoproliferative disorder (PTLD): the prospective international multicentre phase 2 PTLD-1 trial. Lancet Oncol 2012; 13: 196-206. 23. Jain A, Nalesnik M, Reyes J, et al. Posttransplant lymphoproliferative disorders in liver transplantation: a 20-year experience. Ann Surg 2002; 236: 429-37.
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Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Article |
| Authors | |
| Publication Date | December 15, 2019 |
| Submission Date | June 19, 2019 |
| Published in Issue | Year 2019 Volume: 46 Issue: 4 |