Original clinical sciencePost-transplant lymphoproliferative disorder after lung transplantation: A review of 35 cases
Section snippets
Materials and methods
The records of all lung transplant patients treated for PTLD at the HUP Abramson Cancer Center were reviewed. All patients received induction immunosuppression with anti-thymocyte globulin (ATG), daclizumab, or basiliximab. Maintenance immunosuppression regimens included a combination of prednisone, a calcineurin inhibitor (cyclosporine or tacrolimus) and an anti-proliferative agent (azathioprine, mycophenolate mofetil [MMF], or sirolimus).
The presence of disease was confirmed in all patients
Patient characteristics
Between December 1991 and March 2011, 705 patients underwent lung transplantation at the HUP and PTLD developed in 34 (4.8%). One additional patient underwent transplantation at another institution but was treated for PTLD at HUP. Characteristics of our PTLD population are summarized in Table 1. The median age of patients at transplantation of 52 years (range, 21–65 years), and 17 (49%) were women. The most common indication for transplantation was chronic obstructive pulmonary disease,
Discussion
Solid organ transplantation is a well-known risk factor for malignancy.24 It has been postulated that this is due to decreased immunologic surveillance as a consequence of post-transplant immunosuppression.3, 24, 25, 26, 27 One complication of transplantation is PTLD, which has been observed with varying frequency after every type of solid organ transplantation. Although PTLD is more commonly observed after lung transplantation than with other organs,6 it is still a rare disease, with very few
Disclosure statement
None of the authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
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2021, Seminars in Diagnostic PathologyCitation Excerpt :The post-transplant lymphoproliferative disorders (PTLDs) are a family of conditions that are heterogeneous in presentation, morphology, and prognosis, and are often associated with EBV. While these entities may involve any anatomic site, including but not limited to the graft itself, the GI tract represents one of the most common organs affected.84–89 PTLD typically occurs within the first year after hematopoietic stem cell transplant and within the first 4–5 years after solid organ transplant, but late cases have been reported a decade or more after transplant.85,90,91
Malignancy Following Lung Transplantation
2021, Encyclopedia of Respiratory Medicine, Second EditionLymphoid Lesions of the Lung
2018, Pulmonary Pathology: A Volume in the Series: Foundations in Diagnostic PathologyIncreased risk of PTLD in lung transplant recipients with cystic fibrosis
2017, Journal of Cystic FibrosisCitation Excerpt :The highest rates of PTLD occurred in lung transplant recipients who had CF and were EBV seronegative. In this investigation we found a relatively low prevalence of PTLD in both the CF and non-CF populations compared to previously reported studies [2,4–10]. The occurrence we observed in lung transplant recipients is more aligned with reported prevalence of PTLD in other solid organ transplants [3,11–13].