Journal of transplantation · 2025
Posttransplant Lymphoproliferative Disorder (PTLD): 24 Years of Experience at a Referral Center in São Paulo, Brazil. Can Differences in Prevalence and Subtype of EBV Infection in the Population Influence the Results? A Retrospective Cohort Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Vargas Juliano Córdova, Helman Ricardo, Durão Marcelino de Souza, de Arruda Erika Ferraz, Afonso José Eduardo, Carraro Rafael Medeiros, Curvelo Lilian Amorim, Felga Guilherme Eduardo Gonçalves, Matielo Celso Eduardo Lourenço, Almeida Patrícia Holanda, Pasqualin Denise, Stanzione Renata, Perrone Carolina, Perini Guilherme, Hamerschlak Nelson
Аннотация
OBJECTIVES: To retrospectively review all cases of posttransplant lymphoproliferative disorder (PTLD) in a large Brazilian transplant center, describing patients' clinical, virological, and histopathological profiles and treatment strategies and prognostic factors.
METHODS: This retrospective cohort study was conducted between January 2000 and June 2024. Adult patients with confirmed PTLD following solid-organ or bone marrow transplant were included. Patients with other systemic cancers or on concurrent chemotherapy/radiotherapy were excluded. Clinical characteristics, PTLD prevalence, histopathology, and survival were assessed.
RESULTS: Thirty-eight cases of PTLD were identified in the 5928 transplant patients (0.6%). Incidence was highest in lung recipients (31%). Median time to PTLD onset was 42 months. EBV DNA was detectable in 54.8% of cases. Monomorphic PTLD was the most common (89.5%), primarily in non-Hodgkin lymphomas (91.2%). Immunotherapy (anti-CD20) and immunosuppression reduction were standard initial treatments. R-CHOP and rituximab monotherapy were the main first-line regimens. Age and treatment response significantly influenced overall survival. Mortality was 42%, mainly due to infections and disease progression.
CONCLUSIONS: Despite the higher prevalence of EBV in Brazil, PTLD patterns and incidence were consistent with those found in developed countries. The strong association with lung transplants mirrors global data. Local EBV subtype characteristics and host immunogenetic factors warrant further investigation.
METHODS: This retrospective cohort study was conducted between January 2000 and June 2024. Adult patients with confirmed PTLD following solid-organ or bone marrow transplant were included. Patients with other systemic cancers or on concurrent chemotherapy/radiotherapy were excluded. Clinical characteristics, PTLD prevalence, histopathology, and survival were assessed.
RESULTS: Thirty-eight cases of PTLD were identified in the 5928 transplant patients (0.6%). Incidence was highest in lung recipients (31%). Median time to PTLD onset was 42 months. EBV DNA was detectable in 54.8% of cases. Monomorphic PTLD was the most common (89.5%), primarily in non-Hodgkin lymphomas (91.2%). Immunotherapy (anti-CD20) and immunosuppression reduction were standard initial treatments. R-CHOP and rituximab monotherapy were the main first-line regimens. Age and treatment response significantly influenced overall survival. Mortality was 42%, mainly due to infections and disease progression.
CONCLUSIONS: Despite the higher prevalence of EBV in Brazil, PTLD patterns and incidence were consistent with those found in developed countries. The strong association with lung transplants mirrors global data. Local EBV subtype characteristics and host immunogenetic factors warrant further investigation.