Early- and late-onset posttransplant lymphoproliferative disorders among adult kidney and liver transplant recipients

Eur J Haematol. 2022 Oct;109(4):343-350. doi: 10.1111/ejh.13815. Epub 2022 Jul 14.

Abstract

Objectives: Posttransplant lymphoproliferative disorder (PTLD) in solid organ transplant recipients has a high mortality and may present early (<2 years) or late (≥2 years) posttransplantation. We investigated the clinical characteristics of early and late PTLD among kidney and liver transplant recipients.

Methods: Recipients, transplanted at Rigshospitalet, with PTLD development as adults from January 2010 to August 2020, were included. Clinical characteristics, laboratory parameters, and pathology of early and late PTLD were compared.

Results: Thirty-one PTLD cases were detected where 10 (32%) were early and 21 (68%) were late PTLD. EBV DNA in plasma was detected in 78% versus 28% in early and late PTLD (p = .037). None of the recipients with early PTLD and nine recipients with late PTLD (47%) had Ann Arbor stage IV at the time of their diagnosis (p = .006). Cyclophosphamid-Hydroxyrubicin-Oncovin-Prednisolon was used for treatment in 10 (48%) recipients with late PTLD (p = 0.032) only. There was no difference in mortality between the two groups.

Conclusions: Recipients with late PTLD had a lower prevalence of detectable EBV DNA in plasma, were diagnosed with more advanced disease, and were more frequently treated with chemotherapy compared to recipients with early PTLD.

Keywords: kidney transplantation; liver transplantation; posttransplant lymphoproliferative disorder; solid organ transplantation.

MeSH terms

  • Adult
  • Epstein-Barr Virus Infections* / complications
  • Epstein-Barr Virus Infections* / diagnosis
  • Epstein-Barr Virus Infections* / epidemiology
  • Humans
  • Incidence
  • Kidney
  • Liver Transplantation* / adverse effects
  • Lymphoproliferative Disorders* / diagnosis
  • Lymphoproliferative Disorders* / epidemiology
  • Lymphoproliferative Disorders* / etiology
  • Retrospective Studies
  • Risk Factors
  • Transplant Recipients