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- W2590039094 abstract "8054 Background: While it has long been known that PTLD has a predilection to involve the transplanted allograft, little has been reported about this clinical presentation. Methods: A retrospective analysis in adult solid organ transplant patients at our center was performed comparing 48 patients with PTLD involvement of their allograft (P-GRAFT) at diagnosis to 117 patients without involvement (P-WO). Aspects of their presentation, histology, and treatment were compared. Results: Patients with P-GRAFT were similar in sex and age to P-WO (median 48 vs 50 yrs). However at presentation, P-GRAFT differed from P-WO in terms of histology (polymorphic/monomorphic, 67%/33% vs 32%/68%, p= 0.0001), EBV tumor status (86% positive vs 69%, p=0.07), and allograft type (P-GRAFT more common after renal and lung transplant). P-GRAFT occurred sooner after transplantation than P-WO (median time from transplant to diagnosis, 4 vs 53 months, p=<0.0001). 71% of P-GRAFT were diagnosed within 9 months of transplant versus 12% of P-WO (p= <0.0001). The risk of developing P-GRAFT is highest soon after transplantation and decreases after the first year to low levels, whereas P-WO has a stable risk from the time of transplant to years afterwards. Surgical resection (allograft removal) was often curative in allograft only P-GRAFT as it would lead to the complete removal of all tumor and cessation of immunosuppression. Conclusions: PTLD that involves the allograft and non-allograft PTLD are 2 distinct subtypes with unique clinical presentations, histologies and outcomes. The presence of 2 different subtypes with different frequencies over time helps explain known key features of PTLD such as the high risk of EBV positive PTLD soon after organ transplantation and the higher frequency of EBV negative PTLD that occurs years after transplantation. We postulate that these 2 forms of PTLD have different origins. Further laboratory study into the etiology of these 2 forms of PTLD is ongoing." @default.
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- W2590039094 date "2011-05-20" @default.
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- W2590039094 title "Allograft versus non-allograft post-transplant lymphoproliferative disorder, characterization of two distinct subtypes as defined by presentation, histology, and outcome: A case series of 165 patients." @default.
- W2590039094 doi "https://doi.org/10.1200/jco.2011.29.15_suppl.8054" @default.
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