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Characterization and outcome of post-transplant lymphoproliferative disorders within a collaborative study

Background: Post-transplant lymphoproliferative disorders (PTLD) are heterogeneous lymphoid disorders ranging from indolent polyclonal proliferations to aggressive lymphomas that can arise after solid organ transplantation (SOT) and allogeneic hematopoietic transplantation (allo-HSCT). Methods: In t...

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Hauptverfasser: Lückemeier, Philipp (VerfasserIn) , Radujković, Aleksandar (VerfasserIn) , Holtick, Udo (VerfasserIn) , Kurch, Lars (VerfasserIn) , Monecke, Astrid (VerfasserIn) , Platzbecker, Uwe (VerfasserIn) , Herling, Marco (VerfasserIn) , Kayser, Sabine (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 23 June 2023
In: Frontiers in oncology
Year: 2023, Jahrgang: 13, Pages: 1-12
ISSN:2234-943X
DOI:10.3389/fonc.2023.1208028
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fonc.2023.1208028
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/articles/10.3389/fonc.2023.1208028
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Verfasserangaben:Philipp Lückemeier, Aleksandar Radujkovic, Udo Holtick, Lars Kurch, Astrid Monecke, Uwe Platzbecker, Marco Herling and Sabine Kayser

MARC

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520 |a Background: Post-transplant lymphoproliferative disorders (PTLD) are heterogeneous lymphoid disorders ranging from indolent polyclonal proliferations to aggressive lymphomas that can arise after solid organ transplantation (SOT) and allogeneic hematopoietic transplantation (allo-HSCT). Methods: In this multi-center retrospective study, we compare patient characteristics, therapies, and outcomes of PTLD after allo-HSCT and SOT. Twenty-five patients (15 after allo-HSCT and 10 after SOT) were identified who developed PTLD between 2008 and 2022. Results: Median age (57 years; range, 29-74 years) and baseline characteristics were comparable between the two groups (allo-HSCT vs SOT), but median onset of PTLD was markedly shorter after allo-HSCT (2 months vs. 99 months, P<0.001). Treatment regimens were heterogeneous, with reduction of immunosuppression in combination with rituximab being the most common first-line treatment strategy in both cohorts (allo-HSCT: 66%; SOT: 80%). The overall response rate was lower in the allo-HSCT (67%) as compared to the SOT group (100%). Consequently, the overall survival (OS) trended towards a worse outcome for the allo-HSCT group (1-year OS: 54% vs. 78%; P=0.58). We identified PTLD onset ≤150 days in the allo-HSCT (P=0.046) and ECOG >2 in the SOT group (P=0.03) as prognostic factors for lower OS. Conclusion: PTLD cases present heterogeneously and pose unique challenges after both types of allogeneic transplantation. 
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