Chemotherapy for posttransplant lymphoproliferative disorder: the Israel Penn International Transplant Tumor Registry experience

TitleChemotherapy for posttransplant lymphoproliferative disorder: the Israel Penn International Transplant Tumor Registry experience
Publication TypeJournal Article
Year of Publication2005
AuthorsBuell JF, Gross TG, Hanaway MJ, Trofe J, Muthiak C, First MR, Alloway RR, Woodle ES
JournalTransplant Proc
Volume37
Issue2
Pagination956 - 7
Date PublishedMar
Accession Number15848588
KeywordsAntigens, CD / blood, B-Lymphocytes / immunology, Female, Heart Transplantation / *immunology / mortality, Humans, Kidney Transplantation / *immunology / mortality, Liver Transplantation / *immunology / mortality, Lymphoproliferative Disorders / *drug therapy, Male, Pancreas Transplantation / *immunology / mortality, Postoperative Complications / *drug therapy, Recurrence, Registries, Survival Analysis
Abstract

INTRODUCTION: Very little published data exist regarding the results of chemotherapy treatment of posttransplant lymphoproliferative disorder (PTLD). The purpose of the study was to review the Israel Penn International Transplant Tumor Registry experience with PTLD treated with chemotherapy. METHODS: Patients with PTLD who received chemotherapy were identified and data collected regarding demographics, tumor characteristics, recurrence rates, and survival. RESULTS: One hundred ninety three solid organ transplant recipients with PTLD who received chemotherapy were identified. Most patients were male (142:51) and Caucasian (148; 16 AA, 29 unspecified). Most PTLD were B-cell predominant (81%), monoclonal (71), and CD 20+ (60% of patients tested). Organ transplanted included: kidney, 92 (48%); heart, 54 (28%); liver, 30 (16%); pancreas, 8 (4%); and lung, 9 (5%). Median time to presentation posttransplant was 24.5 months (range 0.8 to 226.5 months). Ninety patients received CHOP, 12 ProMACE, 65 other multidrug regimens, and 23 patients received single-agent chemotherapy. Five-year survival for these four regimens were: 24%, 25%, 32%, and 5%. PTLD-specific death rates were 34%, 34%, 40%, and 48%. CONCLUSIONS: Single-agent chemotherapy appears to be inferior to other chemotherapy regimens for PTLD as it is associated with lower survival.

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