Post-Transplantation Lymphoproliferative Disorder After Kidney Transplantation: Report of a Nationwide French Registry and the Development of a New Prognostic Score

被引：107

作者：

Caillard, Sophie ^{[1
]}

Porcher, Raphael ^{[2
]}

Provot, Francois ^{[5
]}

Dantal, Jacques ^{[6
]}

Choquet, Sylvain ^{[3
]}

Durrbach, Antoine ^{[7
]}

Morelon, Emmanuel ^{[8
]}

Moal, Valerie ^{[10
]}

Janbon, Benedicte ^{[11
]}

Alamartine, Eric ^{[12
]}

Noble, Claire Pouteil ^{[9
]}

Morel, Delphine ^{[13
]}

Kamar, Nassim ^{[14
]}

Buchler, Matthias ^{[15
]}

Mamzer, Marie France

Peraldi, Marie Noelle ^{[2
]}

Hiesse, Christian ^{[7
]}

Renoult, Edith ^{[16
]}

Toupance, Olivier ^{[17
]}

Rerolle, Jean Philippe ^{[18
]}

Delmas, Sylvie ^{[19
]}

Lang, Philippe ^{[20
]}

Lebranchu, Yvon ^{[15
]}

Heng, Anne Elisabeth ^{[21
]}

Rebibou, Jean Michel ^{[22
]}

Mousson, Christiane ^{[23
]}

Glotz, Denis ^{[2
]}

Rivalan, Joseph ^{[24
]}

Thierry, Antoine ^{[25
]}

Etienne, Isabelle ^{[26
]}

Moal, Marie Christine ^{[27
]}

Albano, Laetitia ^{[28
]}

Subra, Jean Francois ^{[29
]}

Ouali, Nacera ^{[4
]}

Westeel, Pierre Francois ^{[30
]}

Delahousse, Michel ^{[31
]}

Genin, Robert ^{[32
]}

de Ligny, Bruno Hurault ^{[33
]}

Moulin, Bruno ^{[1
]}

机构：

[1] Strasbourg Univ Hosp, Strasbourg, France

[2] Hop St Louis, Paris, France

[3] La Pitie, Paris, France

[4] Hop Tenon, F-75970 Paris, France

[5] Univ Lille, Lille, France

[6] Univ Nantes, Nantes, France

[7] Univ Kremlin Bicetre, Le Kremlin Bicetre, France

[8] Univ Lyon, Hop Edouard Herriot, Lyon, France

[9] Univ Lyon, Ctr Hosp Lyon Sud, Lyon, France

[10] Univ Marseille, Marseille, France

[11] Univ Grenoble, Grenoble, France

[12] Univ St Etienne, St Etienne, France

[13] Univ Bordeaux, Bordeaux, France

[14] Univ Toulouse, Toulouse, France

[15] Univ Tours, Tours, France

[16] Univ Nancy, Nancy, France

[17] Univ Reims, Reims, France

[18] Univ Limoges, Limoges, France

[19] Univ Montpellier, F-34059 Montpellier, France

[20] Univ Paris 12, Creteil, France

[21] Univ Clermont Ferrand 2, Clermont Ferrand, France

[22] Univ Besancon, F-25030 Besancon, France

[23] Univ Dijon, F-21004 Dijon, France

[24] Univ Rennes, Rennes, France

[25] Univ Poitiers, Poitiers, France

[26] Univ Rouen, Rouen, France

[27] Univ Brest, Brest, France

[28] Univ Nice, Nice, France

[29] Univ Angers, Angers, France

[30] Univ Amiens, Amiens, France

[31] Hop Foch, Suresnes, France

[32] Univ Reunion, St Denis De La Reunion, France

[33] Univ Caen, F-14032 Caen, France

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2013年 / 31卷 / 10期

关键词：

SOLID-ORGAN TRANSPLANTATION; RENAL-TRANSPLANTATION; LYMPHOMAS; DISEASE; IMMUNOSUPPRESSION; RECIPIENTS; RITUXIMAB; SURVIVAL; THERAPY; RISK;

D O I：

10.1200/JCO.2012.43.2344

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose Post-transplantation lymphoproliferative disorder (PTLD) is associated with significant mortality in kidney transplant recipients. We conducted a prospective survey of the occurrence of PTLD in a French nationwide population of adult kidney recipients over 10 years. Patients and Methods A French registry was established to cover a nationwide population of transplant recipients and prospectively enroll all adult kidney recipients who developed PTLD between January 1, 1998, and December 31, 2007. Five hundred patient cases of PTLD were referred to the French registry. The prognostic factors for PTLD were investigated using Kaplan-Meier and Cox analyses. Results Patients with PTLD had a 5-year survival rate of 53% and 10-year survival rate of 45%. Multivariable analyses revealed that age > 55 years, serum creatinine level > 133 mu mol/L, elevated lactate dehydrogenase levels, disseminated lymphoma, brain localization, invasion of serous membranes, monomorphic PTLD, and T-cell PTLD were independent prognostic indicators of poor survival. Considering five variables at diagnosis (age, serum creatinine, lactate dehydrogenase, PTLD localization, and histology), we constructed a prognostic score that classified patients with PTLD as being at low, moderate, high, or very high risk for death. The 10-year survival rate was 85% for low-, 80% for moderate-,56% for high-, and 0% for very high- risk recipients. Conclusion This nationwide study highlights the prognostic factors for PTLD and enables the development of a new prognostic score. After validation in an independent cohort, the use of this score should allow treatment strategies to be better tailored to individual patients in the future. J Clin Oncol 31:1302-1309. (C) 2013 by American Society of Clinical Oncology

引用

页码：1302 / 1309

页数：8

共 29 条

[1] Anti-B-cell monoclonal antibody treatment of severe posttransplant B-lymphoproliferative disorder: Prognostic factors and long-term outcome [J].