Bone marrow involvement by lymphoproliferative disorders post liver transplantation: PTLD Int Survey.

AIM: to analyze cases of BM PTLD in liver transplant recipients to find any specific predictor or prognostic factor associated with this disease localization.

METHODS

a comprehensive search of the existing literature was performed, and 173 liver recipients who had developed PTLD in their post transplant course from 19 studies were found and enrolled into analysis. 36 of the patients were BM PTLD cases and the remaining was used as controls.

RESULTS

liver transplant recipients with BM PTLD were significantly more likely to represent in male patients (p=0.042) and the elderly (p=0.08). BM PTLD was significantly more likely to complicate liver allograft (p=0.027) and spleen (p=0.013). Histopathological evaluations showed that BM PTLD lesions were more likely of monomorphic type (p=0.025). Multi-organ and disseminated PTLD were significantly more prevalent among BM PTLD patients (p<0.001, both) The BM PTLD group represented relatively lower survival than patients with other localizations, although it did not reach significant level (p=0.1).

CONCLUSION

our findings alert us to use more sensitive methods to find potential simultaneous metastatic lesions in the mentioned organs for liver recipients developing BM PTLD. Future studies with prospective approaches are needed to confirm our findings.