Decreased survival in hepatitis C patients with monomorphic post-transplant lymphoproliferative disorder after liver transplantation treated with frontline immunochemotherapy. Issue 9 (2nd September 2018)

• Record Type: Journal Article
• Authors: Alderuccio, Juan Pablo; Stefanovic, Alexandra; Dammrich, Daniel; Chapman, Jennifer R.; Vega, Francisco; Selvaggi, Gennaro; Tzakis, Andreas; Lossos, Izidore S.
• Is Part Of: Leukemia & lymphoma. Volume 59:Issue 9(2018)
• Page Start: 2096
• Page End: 2104
• Publication Date: 2018-09-02
• Subjects: Post-transplant lymphoproliferative disorder -- liver transplant -- hepatitis C virus and immunochemotherapy; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2017.1413187
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Post-transplant lymphoproliferative disorder (PTLD) develops in 1–3% of liver transplant recipients and no consensus exists about therapeutic management. From 2006 to 2016, 1489 liver transplants were performed at our institution with 20 patients (incidence 1.3%) developing PTLD. Hepatitis C virus (HCV) was the leading cause ( n = 10) of liver transplant in PTLD patients. Diffuse large B-cell lymphoma was the most frequent histologic subtype ( n = 17), and we report our experience in the management of these patients. Patients were treated with frontline immunochemotherapy without immunosuppression reduction. All evaluable patients achieved a complete remission. Statistically significant decreased survival was identified in HCV-positive patients. Six patients (60%) exhibited increases in HCV RNA levels during therapy. Four patients (40%) developed graft failure and three of them (30%) died from liver dysfunction. This is the first study providing evidence of decreased survival in HCV-positive PTLD patients after liver transplant receiving immunochemotherapy.