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Immunosurveillance, Immunodeficiencies and Lymphoproliferations pp 67–80Cite as

Identification of Prognostic Factors in Post-Transplant Lymphoproliferative Disorders

  • Conference paper

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 159))

Abstract

Organ transplantations can lead to post-transplant lymphoproliferative disorders (PT-LPDs) as a result of immunosuppressive therapy. PT-LPDs clearly differ from non-Hodgkin’s lymphomas occurring in immunocompetent patients, in terms of clinical presentation, pathological findings and treatment response. Several studies have tried to establish some prognostic factors but the small number of patients hinders the analysis. We studied 61 patients from two transplant centers who developed a PT-LPD after kidney (34 patients), heart (19 patients), lung (4 patients) or liver (3 patients) transplantation. Treatment consisted of modification of the immunosuppressive regimen, chemotherapy and/or monoclonal antibody infusions. Analyzing potential prognostic factors, we found that factors predictive of failure to achieve a complete remission were, in univariate analysis, a performance status (PS) ≥2 and negativity of the tumor for the Epstein-Barr virus (EBV), and in multivariate analysis, only the PS. Factors predictive of lower survival were, in univariate analysis, a PS >2, number of sites > 1, primary central nervous system (CNS) location, T-cell phenotype, monoclonality of the tumor, tumor negativity for EBV and chemotherapy as a first treatment; in multivariate analysis. only PS and the number of sites were statistically significant. The International Prognostic Index (IPI) failed to identify a patient subgroup with a lower survival or treatment response, whereas a simple index using PS and number of sites clearly identified three different groups. The median survival has not yet been reached in the lowerrisk group, whereas it is 34 months in the intermediate-risk patients and 1 month in the high-risk group. Studies on larger cohorts of patients need to be performed to confirm these data.

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Authors and Affiliations

  1. Département d’Hématologie, Hôpital Pitié-Salpétrière, 47-83, Boulevard de l’Hôpital, 75651, Paris Cedex 13, France

    Sylvain Choquet, Stephanie Nguyen Quoc, Jean-Paul Vernant & Véronique Leblond

  2. Service de Néphrologie, Hôpital Necker, Paris, France

    Marie-France Mamzer Bruneel

  3. Service d’Hématologie, Hôpital Necker, Paris, France

    Olivier Hermine

  4. Département de Biostatistiques et Informatique Médicale, Hôpital Saint-Louis, Paris, France

    Raphaël Porcher & Vincent Levy

  5. Laboratoire d’Hématologie, Hôpital Pitié-Salpétrière, Paris, France

    Frédéric Davi

  6. Laboratoire d’Anatomopathologie, Hôpital Pitié-Salpétrière, Paris, France

    Frédéric Charlotte

  7. Service de Chirurgie Thoracique, Hôpital Pitié, Salpétrière, Paris, France

    Richard Dorent

  8. Service d’Urologie et de Transplantation Rénale, Hôpital Pitié-Salpétrière, Paris, France

    Benoit Barrou

  9. Service d’Hématologie Biologique, Hôpital Avicenne, Bobigny, France

    Martine Raphael

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  1. Sylvain Choquet
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  2. Marie-France Mamzer Bruneel
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  5. Stephanie Nguyen Quoc
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  6. Frédéric Davi
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  7. Frédéric Charlotte
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  8. Richard Dorent
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  9. Benoit Barrou
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  10. Jean-Paul Vernant
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  11. Martine Raphael
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  12. Vincent Levy
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  13. Véronique Leblond
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Editors and Affiliations

  1. Universitätsklinikum Charité-Campus Virchow Medizinische Klinik mit Schwerpunkt Hämatologie/Onkologie, Humboldt Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Stephan H. Oertel  & Hanno Riess  & 

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© 2002 Springer-Verlag Berlin Heidelberg

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Choquet, S. et al. (2002). Identification of Prognostic Factors in Post-Transplant Lymphoproliferative Disorders. In: Oertel, S.H., Riess, H. (eds) Immunosurveillance, Immunodeficiencies and Lymphoproliferations. Recent Results in Cancer Research, vol 159. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56352-2_9

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  • DOI: https://doi.org/10.1007/978-3-642-56352-2_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62676-0

  • Online ISBN: 978-3-642-56352-2

  • eBook Packages: Springer Book Archive

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