Posttransplant lymphoproliferative disorder in pediatric patients: Survival rates according to primary sites of occurrence and a proposed clinical categorization.
Epstein-Barr Virus (EBV)
cancer/malignancy/neoplasia
classification systems
clinical research/practice
hematogenous/leukemia/lymphoma
hematology/oncology
infection and infectious agents - viral
infectious disease
patient survival
pediatrics
posttransplant lymphoproliferative disorder (PTLD)
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
29
08
2018
revised:
06
03
2019
accepted:
10
03
2019
pubmed:
19
3
2019
medline:
5
9
2020
entrez:
19
3
2019
Statut:
ppublish
Résumé
Posttransplant lymphoproliferative disorder (PTLD) is a devastating complication of organ transplant. In a hospital-based registry, we identified biopsy-proven cases of PTLD among children during a 15-year period and reviewed trends in PTLD rates, the sites of involvement, and the associated survival rates. Cases that were included had at least 1 year of follow-up after the diagnosis of PTLD. We studied 82 patients with first-episode PTLD. Median age at diagnosis was 6.4 years (IQR 3.2-12.3 years). The most frequent PTLD sites were tonsillar/adenoidal (T/A [34%]) and gastrointestinal (32%), followed by miscellaneous (defined as less common sites including central nervous system, kidney, lung, and soft tissue [12%]), lymph node (11%), and multisite (11%). Kaplan-Meier survival curves showed that T/A PTLD was associated with decreased all-cause mortality compared with PTLD at other sites (log-rank 0.004), even after adjustment for histological subtype (P = .047). PTLD-related mortality was also decreased among T/A PTLD (log-rank 0.012) but showed a trend toward significance only after adjustment for histological subtype (P = .09). Among first episodes of PTLD, T/A PTLD was associated with a survival advantage compared with PTLD at other sites, even after adjustment for potential confounders. Based on our observations, we propose a clinical categorization of PTLD according to anatomical site of occurrence.
Identifiants
pubmed: 30884098
doi: 10.1111/ajt.15358
pii: S1600-6135(22)09261-9
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2764-2774Subventions
Organisme : Hospital for Sick Children
Pays : International
Informations de copyright
© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons.
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