Frequency, characteristics, and outcome of PTLD after allo‐SCT: A multicenter study from the Spanish group of blood and marrow transplantation (GETH). (10th April 2019)

• Record Type: Journal Article
• Authors: García‐Cadenas, Irene; Yáñez, Lucrecia; Jarque, Isidro; Martino, Rodrigo; Pérez‐Simón, Jose Antonio; Valcárcel, David; Sanz, Jaime; Bermúdez, Arantxa; Muñoz, Cristina; Calderón‐Cabrera, Cristina; García, Estefania; Alonso, Laura; Suárez‐Lledó, Maria; González Vicent, Marta; Heras, Inmaculada; Viguria, Mª Cruz; Batlle, Montserrat; Vázquez, Lourdes; López, Javier; Solano, Carlos
• Is Part Of: European journal of haematology. Volume 102:Number 6(2019)
• Page Start: 465
• Page End: 471
• Publication Date: 2019-04-10
• Subjects: allo‐SCT -- EBV -- infection -- PTLD -- rituximab; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.13226
• Languages: English
• ISSNs: 0902-4441

Abstract

Abstract: Post‐transplant lymphoproliferative disorder (PTLD) is an infrequent complication of allogeneic stem cell transplant (allo‐SCT). Aims: To estimate the frequency and management of PTLD in Spain and to identify prognostic factors influencing outcomes. Methods: Multicenter, retrospective analysis of allo‐SCT performed in 14 transplant units over a 15‐year period. Results: 102 PTLD were diagnosed among 12 641 allo‐SCT, leading to an estimated frequency of 0.8%. PTLD was diagnosed at a median of 106 days after SCT. Eighty‐seven cases (85%) were diagnosed between 2007 and 2013. At diagnosis, 22% and 17% of the patients had gastrointestinal tract and CNS involvement. Eighty‐seven (85%) received rituximab treatment, alone or in combination with immunosuppression reduction, with an ORR of 50.6%. With a median follow‐up for survivors of 58 months, the 2‐year overall survival (OS) was 33% and the PTLD‐related mortality 45%. Age ≥ 40 years, malignant underlying disease, non‐response to rituximab, and severe thrombocytopenia or lymphocytopenia at PTLD diagnosis were associated with worse overall survival. Conclusions: Only a small proportion of allografted patients were diagnosed a PTLD. Its clinical course was highly aggressive, and prognosis poor, especially in those failing rituximab. The prognostic impact found of the platelet, and lymphocyte count at diagnosis requires further confirmation.