Risk of lymphoproliferative disorders after bone marrow transplantation: a multi-institutional study

TitleRisk of lymphoproliferative disorders after bone marrow transplantation: a multi-institutional study
Publication TypeJournal Article
Year of Publication1999
AuthorsCurtis RE, Travis LB, Rowlings PA, Socie G, Kingma DW, Banks PM, Jaffe ES, Sale GE, Horowitz MM, Witherspoon RP, Shriner DA, Weisdorf DJ, Kolb HJ, Sullivan KM, Sobocinski KA, Gale RP, Hoover RN, F., Fraumeni J. J, Deeg HJ
JournalBlood
Volume94
Issue7
Pagination2208 - 16
Date PublishedOct 1
Accession Number10498590
KeywordsAdolescent, Adult, Anemia, Aplastic / therapy, Bone Marrow Transplantation / *adverse effects / immunology, Child, Cohort Studies, Female, Graft vs Host Disease / prevention & control, Histocompatibility Testing, Humans, Immunosuppression / methods, Immunosuppressive Agents / therapeutic use, Leukemia / therapy, Lymphocyte Depletion, Lymphoproliferative Disorders / *epidemiology, Male, Postoperative Complications / *epidemiology, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S., Risk Factors, T-Lymphocytes / immunology, Transplantation, Homologous, United States / epidemiology
Abstract

We evaluated 18,014 patients who underwent allogeneic bone marrow transplantation (BMT) at 235 centers worldwide to examine the incidence of and risk factors for posttransplant lymphoproliferative disorders (PTLD). PTLD developed in 78 recipients, with 64 cases occurring less than 1 year after transplantation. The cumulative incidence of PTLD was 1.0% +/- 0.3% at 10 years. Incidence was highest 1 to 5 months posttransplant (120 cases/10,000 patients/yr) followed by a steep decline to less than 5/10,000/yr among >/=1-year survivors. In multivariate analyses, risk of early-onset PTLD (/=3 major risk factors were 8.0% +/- 2.9% and 22% +/- 17.9%, respectively. We conclude that factors associated with altered immunity and T-cell regulatory mechanisms are predictors of both early- and late-onset PTLD.

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