Risk factors for early-onset and late-onset post-transplant lymphoproliferative disorder in kidney recipients in the United States

被引:157
作者
Quinlan, Scott C. [1 ]
Pfeiffer, Ruth M. [1 ]
Morton, Lindsay M. [1 ]
Engels, Eric A. [1 ]
机构
[1] NCI, Infect & Immunoepidemiol Branch, Div Canc Epidemiol & Genet, DHHS, Rockville, MD 20892 USA
关键词
NON-HODGKIN-LYMPHOMA; EPSTEIN-BARR-VIRUS; SOLID-ORGAN TRANSPLANTATION; RENAL-TRANSPLANTATION; DISTINCT ENTITY; IMMUNOSUPPRESSION; EPIDEMIOLOGY; DISEASE; MALIGNANCY; INFECTION;
D O I
10.1002/ajh.21911
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Solid-organ transplant recipients have an elevated risk for some malignancies because of the requirement for immunosuppression [1]. In particular, non-Hodgkin's lymphoma (NHL) is common and comprises one end of a spectrum of post-transplant lymphoproliferative disorder (PTLD) ranging from benign hyperplasia to lymphoid malignancy [2]. PTLD risk is influenced by the type of organ transplanted, the age and Epstein-Barr virus (EBV) serostatus of the transplant recipient, and the intensity of immunosuppression [3-9]. PTLD incidence is high immediately after transplantation, decreases subsequently, and then rises again 4-5 years from transplantation [10,11]. This incidence pattern suggests the presence of separate early-onset and late-onset PTLD subtypes. Early-onset PTLDs tend to be EBV-positive and, when extranodal, are more likely than late-onset PTLDs to be localized to the transplanted organ [12,13]. Late-onset PTLD is less likely to be associated with EBV and, overall, is more likely than early-onset PTLD to be extranodal [13,14]. The Scientific Registry of Transplant Recipients (SRTR) includes data on a large number of solid-organ transplant recipients in the United States and information on malignancies diagnosed post-transplantation. We used these data to conduct a retrospective cohort study among kidney transplant recipients to examine differences in risk factors between early-onset PTLD and late-onset PTLD.
引用
收藏
页码:206 / 209
页数:4
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