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• W2017833093 abstract "P844 Post transplant lymphoproliferative disorder (PTLD) is the second most common transplant related malignancy after skin cancer. CNS involvement of PTLD is uncommon, however when present, it may indicated increased morbidity and or mortality. The purpose of this study was to analyze outcome in solid organ transplant recipients with CNS involvement by PTLD. Methods: 910 PTLD cases reported to the US component of the Israel Penn International Transplant Tumor Registry (IPITTR) were reviewed for the presence of CNS involvement. Cases were reviewed for patient and tumor demographics, therapy and overall patient survival. Results: 136 cases (15%) of all PTLD cases had CNS involvement. The highest incidence of CNS involvement was in pancreas (3/11;27%), followed by kidney (76/429;18%), heart (37/296;13%), liver (16/142;11%), and lung transplants (4/32;13%). [Panc vs other p<0.01] 15 cases occurred in pediatric patients (mean age 9.5 ±6.5 yrs.) and 121 cases in adults (mean age of 44.3 ± 13.9 yrs.). Time from transplant to presentation was similar in adults and children (21.6 ±35.9 vs. 27.3 ± 33.1 mos; p=NS). The majority of pediatric and adult tumors were B cell (89% and 93%), monoclonal (67% and 68%), and EBV positive (90% and 82%). Overall survival was dismal for both groups. Pediatric patients had a 13% (2/15) 3-yr survival [2 survivors received external beam irradiation (XRT)]. The adult group had a 9% (11/121) 3-yr survival, (7 with CNS only involvement, 6 received XRT, and 4 multi-site with CNS involvement, 3 received XRT). Frequency of isolated CNS involvement was similar in children (47%) and adults (48%). Pediatric patients with isolated CNS disease had superior survival over those with multiple sites (29% vs. 0%) in distinct contrast to adults, (12% vs. 6%;p<0.05). XRT alone appeared to provide the best therapeutic results with 7/28 (25%) survivors. Patients with PTLD involving CNS only had a higher survival compared to patients with PTLD involving CNS plus extracranial tumors (13.8 vs. 5.6%; p<0.05) Conclusion: 1) The presence of CNS involvement by PTLD in both adult and children is associated with extremely poor survival, 2) Isolated CNS PTLD has a better prognosis in children, but not adults, and 3) XRT when used alone in selected patients, appears to provide higher survival rates." @default.
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• W2017833093 date "2004-07-01" @default.
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• W2017833093 title "POST TRANSPLANT LYMPHOPROLIFERATIVE DISORDER: THE SIGNIFICANCE OF CENTRAL NERVOUS SYSTEM INVOLVEMENT" @default.
• W2017833093 doi "https://doi.org/10.1097/00007890-200407271-01340" @default.
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