Outcomes and Prognostic Assessment of Post-Transplant Lymphoproliferative Disorder: 20-Year Experience
Post-transplant lymphoproliferative disorder (PTLD) is the most common malignancy in adults who receive solid organ transplantation (SOT), apart from skin cancer. It is a serious and potentially fatal complication of chronic immunosuppression (ISI) in SOT recipients. This report describes a 20-year...
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MDPI AG
2025-02-01
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| Series: | Lymphatics |
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| author | Hira Shaikh Zulfa Omer Koffi Wima Tara Magge Shimul A. Shah Tahir Latif |
| author_facet | Hira Shaikh Zulfa Omer Koffi Wima Tara Magge Shimul A. Shah Tahir Latif |
| author_sort | Hira Shaikh |
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| description | Post-transplant lymphoproliferative disorder (PTLD) is the most common malignancy in adults who receive solid organ transplantation (SOT), apart from skin cancer. It is a serious and potentially fatal complication of chronic immunosuppression (ISI) in SOT recipients. This report describes a 20-year (2001–2021) clinicopathological experience with 59 PTLD patients at an urban center. The median time from transplant to PTLD was 8.5 years and the most common types of transplants were kidney (41%) and liver (31%). Epstein–Barr encoding region (EBER) was positive in 51% tumors, and 50% patients had Epstein–Barr virus (EBV) viremia at diagnosis. Overall survival (OS) at 1 year and 5 years was 78% and 64%, respectively. OS was significantly (<i>p</i> < 0.05) shorter in males (hazard ratio [HR] 3.7), certain organ transplants (lung HR 10.4; liver HR 3.9 relative to kidney), PTLD diagnosed within 12 months of transplant (HR 4.1), multi-organ involvement at diagnosis (HR 7.1), vitamin D deficiency at diagnosis (HR 4.5), and low serum albumin level at diagnosis (HR 3.6). Our study highlights the prognostic factors of PTLD and corroborates improved PTLD outcomes in the past 20 years. |
| format | Article |
| id | doaj-art-1f8de7d1bf6d4fdf8f7b448389fee48e |
| institution | OA Journals |
| issn | 2813-3307 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
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| series | Lymphatics |
| spelling | doaj-art-1f8de7d1bf6d4fdf8f7b448389fee48e2025-08-20T02:24:46ZengMDPI AGLymphatics2813-33072025-02-0131510.3390/lymphatics3010005Outcomes and Prognostic Assessment of Post-Transplant Lymphoproliferative Disorder: 20-Year ExperienceHira Shaikh0Zulfa Omer1Koffi Wima2Tara Magge3Shimul A. Shah4Tahir Latif5Department of Hematology-Oncology and Bone Marrow Transplantation, University of Iowa Healthcare, Iowa City, IA 52242, USADepartment of Hematology-Oncology, University of Cincinnati Medical Center, Cincinnati, OH 45267, USADepartment of Surgery, University of Cincinnati, Cincinnati, OH 45219, USAHematology-Oncology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15232, USADepartment of Surgery, University of Cincinnati, Cincinnati, OH 45219, USADepartment of Hematology-Oncology, University of Cincinnati Medical Center, Cincinnati, OH 45267, USAPost-transplant lymphoproliferative disorder (PTLD) is the most common malignancy in adults who receive solid organ transplantation (SOT), apart from skin cancer. It is a serious and potentially fatal complication of chronic immunosuppression (ISI) in SOT recipients. This report describes a 20-year (2001–2021) clinicopathological experience with 59 PTLD patients at an urban center. The median time from transplant to PTLD was 8.5 years and the most common types of transplants were kidney (41%) and liver (31%). Epstein–Barr encoding region (EBER) was positive in 51% tumors, and 50% patients had Epstein–Barr virus (EBV) viremia at diagnosis. Overall survival (OS) at 1 year and 5 years was 78% and 64%, respectively. OS was significantly (<i>p</i> < 0.05) shorter in males (hazard ratio [HR] 3.7), certain organ transplants (lung HR 10.4; liver HR 3.9 relative to kidney), PTLD diagnosed within 12 months of transplant (HR 4.1), multi-organ involvement at diagnosis (HR 7.1), vitamin D deficiency at diagnosis (HR 4.5), and low serum albumin level at diagnosis (HR 3.6). Our study highlights the prognostic factors of PTLD and corroborates improved PTLD outcomes in the past 20 years.https://www.mdpi.com/2813-3307/3/1/5post-transplant lymphoproliferative disordersolid organ transplantsurvivaloutcomesmortality |
| spellingShingle | Hira Shaikh Zulfa Omer Koffi Wima Tara Magge Shimul A. Shah Tahir Latif Outcomes and Prognostic Assessment of Post-Transplant Lymphoproliferative Disorder: 20-Year Experience Lymphatics post-transplant lymphoproliferative disorder solid organ transplant survival outcomes mortality |
| title | Outcomes and Prognostic Assessment of Post-Transplant Lymphoproliferative Disorder: 20-Year Experience |
| title_full | Outcomes and Prognostic Assessment of Post-Transplant Lymphoproliferative Disorder: 20-Year Experience |
| title_fullStr | Outcomes and Prognostic Assessment of Post-Transplant Lymphoproliferative Disorder: 20-Year Experience |
| title_full_unstemmed | Outcomes and Prognostic Assessment of Post-Transplant Lymphoproliferative Disorder: 20-Year Experience |
| title_short | Outcomes and Prognostic Assessment of Post-Transplant Lymphoproliferative Disorder: 20-Year Experience |
| title_sort | outcomes and prognostic assessment of post transplant lymphoproliferative disorder 20 year experience |
| topic | post-transplant lymphoproliferative disorder solid organ transplant survival outcomes mortality |
| url | https://www.mdpi.com/2813-3307/3/1/5 |
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