Prognostic Analysis for Survival in Adult Solid Organ Transplant Recipients With Post-Transplantation Lymphoproliferative Disorders
- 20 October 2005
- journal article
- hematologic malignancies
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 23 (30), 7574-7582
- https://doi.org/10.1200/jco.2005.01.0934
Abstract
Purpose: The objective of this study was to determine prognostic factors for overall survival in patients with post-transplantation lymphoproliferative disorders (PTLDs). Patients and Methods: This study focused on the 107 adult solid organ transplantation patients who were diagnosed with PTLDs at Mayo Clinic (Rochester, MN) between December 1970 and May 2003. Results: The median age at the time of diagnosis was 48 years (range, 15 to 75 years). Extranodal disease including grafted organ involvement was present in 85 patients (80%). The graft organ was involved in 30 patients (28%). At the time of these analyses, 62 patients (58%) had died. The median survival for the entire cohort was 31.5 months (95% CI, 10.7 to 72.5 months). The median follow-up of living patients was 51.8 months (range, 5.6 to 202.6 months). In univariate analyses for overall survival from the time of PTLD diagnosis, the following poor prognostic factors were identified: poor performance status with Eastern Cooperative Oncology Group levels 3 and 4 (P < .0001), grafted organ involvement (P = .0005), the presence of one or more extranodal sites (P = .005), both nodal and extranodal disease (P = .002), high International Prognostic Index (P = .006), advanced stage (P = .001), and elevated lactate dehydrogenase (P = .03). A final multivariable model for survival was constructed using three factors: poor performance status (3 to 4), monomorphic disease, and graft organ involvement. Conclusion: A prognostic model has been developed for PTLD patients using one center's 30 years of experience. We propose additional confirmation and validation of these prognostic factors in larger prospective studies.This publication has 19 references indexed in Scilit:
- Post-Transplant Lymphoproliferative Disorder in the United States: Young Caucasian Males are at Highest RiskAmerican Journal of Transplantation, 2002
- INFLUENCE OF HOST-RECIPIENT ORIGIN ON CLINICAL ASPECTS OF POSTTRANSPLANTATION LYMPHOPROLIFERATIVE DISORDERS IN KIDNEY TRANSPLANTATIONTransplantation, 2002
- Post renal transplantation human herpesvirus 8‐associated lymphoproliferative disorder and Kaposi's sarcomaBritish Journal of Haematology, 2001
- Epstein–Barr Virus-Negative Post-Transplant Lymphoproliferative DisordersThe American Journal of Surgical Pathology, 2000
- EPSTEIN-BARR VIRUS-INDUCED POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDERSTransplantation, 1999
- Posttransplant lymphoproliferative disorders not associated with Epstein-Barr virus: a distinct entity?Journal of Clinical Oncology, 1998
- Post-transplantation lymphoproliferative disorder in the Epstein-Barr virus-naïve lung transplant recipient.American Journal of Respiratory and Critical Care Medicine, 1996
- Posttransplantation Lymphoproliferative Disorders in Solid Organ Recipients Are Predominantly Aggressive Tumors of Host OriginAmerican Journal of Clinical Pathology, 1995
- Pretransplantation Assessment of the Risk of Lymphoproliferative DisorderClinical Infectious Diseases, 1995
- Cancers Complicating Organ TransplantationThe New England Journal of Medicine, 1990