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Title

Posttransplant lymphoproliferative disorder in pediatric patients: Survival rates according to primary sites of occurrence and a proposed clinical categorization

Authors
Dipchand, Anne I
Ng, Vicky L
Hebert, Diane
Avitzur, Yaron
Solomon, Melinda
Ngan, Bo-Yee
Stephens, Derek
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Published in American Journal of Transplantation. 2019, vol. 19, no. 10, p. 2764-2774
Abstract 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.
Keywords AdolescentChildChild, PreschoolFemaleFollow-Up StudiesHumansLymphoproliferative Disorders/etiology/mortality/pathologyMaleOrgan Transplantation/adverse effects/mortalityPostoperative Complications/etiology/mortality/pathologyPrognosisRegistries/statistics & numerical dataRisk FactorsSurvival Rate
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PMID: 30884098
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Article (Published version) (800 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Research group Recherche en infectiologie pédiatrique et en pédiatrie générale (853)
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L'HUILLIER, Arnaud et al. Posttransplant lymphoproliferative disorder in pediatric patients: Survival rates according to primary sites of occurrence and a proposed clinical categorization. In: American Journal of Transplantation, 2019, vol. 19, n° 10, p. 2764-2774. doi: 10.1111/ajt.15358 https://archive-ouverte.unige.ch/unige:146819

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Deposited on : 2020-12-18

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