Array‐CGH predicts prognosis in plasma cell post‐transplantation lymphoproliferative disorders. Issue 3 (1st November 2016) - Sarkozy, Clémentine
Abstract : Plasma‐cell post‐transplantation lymphoproliferative disorder (PC‐PTLD) is a rare monomorphic PTLD entity divided into plasma cell myeloma (PCM) and plasmacytoma‐like lesion (PLL) PTLD. To date, there are no exhaustive published cytogenetic data on PC‐PTLD. We report array‐based comparative genomic hybridization (aCGH) of 10 cases of PCM and PLL‐PTLD. Patients had received kidney ( n = 6), heart ( n = 2), lung ( n = 1) or bone marrow ( n = 1) transplantation. There were six men and median age at time of PTLD was 56.5 years (3–74). We identified two different cytological features, plasmacytic and plasmablastic, among six PLL and three PCM PTLD. Eight cases were associated with EBV. First line treatment was heterogeneous: rituximab alone ( n = 5), CHOP‐like ( n = 3) and multiple myeloma‐like ( n = 1). One patient died before any treatment. After a median follow‐up of 19.5 months (0–150), five patients died (four from PTLD) and five were alive without evidence of disease. By aCGH, 5/10 demonstrated a complex profile. The most frequent abnormalities were +7q (5/10), +16q (5/10), +17q (5/10), +17p (4/10), +5q (4/10), t7 (4/10), t9 (3/10), del1p (3/10). No del17p13 (TP53) were observed. Del1p32.3 (CDKN2C) was observed in 2 cases. On univariate prognostic analysis, a complex aCGH was associated with a shorter OS. Thus, cytogenetic abnormalities seem to be closely related to those reported in multiple myeloma or diffuse large B cell lymphoma. Complex aCGH constitutes an unfavorable prognostic marker and aCGH should be integrated in the evaluation of patients with PLL/PCM‐PTLD. © 2016 Wiley Periodicals, Inc.