King Edward Medical University, Lahore, Pakistan
Mobeen Zaka Haider , Zarlakhta Zamani , Hasan Mehmood Mirza , Hafsa Shahid , Muhammad Taqi , Yousra Khalid , Mohsin Sheraz Mughal , Fnu Kiran , Deepak Kumar , Ahsan Wahab , Muhammad Salman Faisal , Muhammad Umair Mushtaq , Faiz Anwer
Background: Post-transplant lymphoproliferative disorder (PTLD) is a complication after liver transplantation. This study aims to explore the association of PTLD with the immunosuppression, types of PTLD, clinical presentation, and outcomes. Methods: Following the PRISMA guideline, we searched the literature on PubMed, Cochrane, Embase, and clinicaltrials.gov. 1741 articles were screened and 22 studies were included. Results: Data includes 22,235 total patients who underwent a liver transplant, and 449 (2.0%) patients who developed PTLD were studied. Of the 394 patients where gender was reported, 226 were male and 168 were female. Post-transplant EBV status was positive for 63/115 (56%). 11 studies showed that the median time from transplant to the development of PTLD was 33.4 months. Among the histological types of PTLD, the monomorphic B-cell was the most common type with 127/235 (54%) cases, followed by early lesions 25/235, polymorphic 24/235, Hodgkin lymphoma 8/235, and monomorphic T-cell type 7/235. Treatment of PTLD involved reduction or cessation of the immunosuppressive drugs along with chemotherapy surgery and radiotherapy. Mortality data from 13 studies showed 68/259 (31.3%) patients died either due to PTLD or its complication. Conclusions: PTLD is rare but associated with high mortality after liver transplantation. EBV seropositivity is associated with PTLD in the majority of cases. Monomorphic PTLD is the most common type of PTLD after liver transplantation with DLBCL being the most common subtype. Abdominal symptoms and fever are among the most common symptoms. PTLD after Liver transplant a review of studies.
Study | Total n | PTLD patients | M/F | EBV Status | Type of PTLD | Median Duration | Mortality |
---|---|---|---|---|---|---|---|
Fararjeh | 45 | 45 | 25/20 | + : 16/45 | Early:3; Mono B:34; Mono T:2; Poly:4; HL:1 | 56 m | 16/25 |
Jamalidoust | 696 | 34 | 17/17 | +: 19/34 | Mono(DLBCL):5; HL:1; NHL:1; MALT: 1; UC:26 | 11/34 | |
Dorado | 851 | 10 | 8/2. | PreTx: D+: 6; R+: 5 | Mono: 7; Poly: 2; Early: 1 | M: 33 m | 5/10 |
Ozkan | 2148 | 7 | 4/3 | + : 4/7 | MonoB(DLBCL): 4; Mono T: 1; Early lesion:2 | M: 75.2 m | |
Bellido | 1071 | 18 | 14/4 | PreTx: R+: 6; D+:5 | Mono B: 12; Mono T: 2; HL:1; Early: 3 | 3.9 y | |
Ozkan | 2224 | 12 | 7/5 | Mono B: 5; Mono T: 1; Mixed Mono & Poly: 2; Early lesion: 4 | M: 27 m | 1/12 | |
Alderuccio | 1489 | 20 | 15/5 | PreTx: D+: 4 | Mono; DLBCL: 17; HL: 1; Plasmacytoma: 2; | 82 m | 8/20 |
Cruz | 5677 | 36 | 20/16 | PreTx +: 17/36 | Monomorphic: 25/36; Early onset: 4/36; Mixed type: 1/36; UC: 1/36 | M: 7.2 y | |
Valls | 715 | 6 | PreTx+: 3/6 | Mono:5/6 (DLBCL); Plasmacytic: 1/6 | 14 m | 4/6 | |
Pinho- appezato | 303 | 13 | PreTx: D+: 7; R+:3 PostTx: R+: 11/13 | Mono B: 7/13 (DLBCL: 4, Burkitt:2, NHL:1) Poly: 6/13 | 13m | 7/13 | |
Hsu | 110 | 16 | 8/8 | PreTx: R+: 1/16; PostTx R+:15/16 | Mono B: 5; Mono Burkitt: 2; Mono T: 1; HL: 1; Poly:6; Early:1 | 8m | 3/16 |
Huang | 110 | 18 | 9/9 | Mono B: 2; Poly:1; Early: 13; HL: 1 | 8.9 m | 3/18 | |
Karakoyun | 206 | 7 | 2/5 | PreTx: + 3/7 | B Cell: 2; T Cell: 1; HL: 2; EBV rel 2 | 24 m | 1/7 |
DLBCL: diffuse large B cell lymphoma; HL: Hodgkin Lymphoma; M:mean, m: months; NHL: Non-Hodgkin Lymphoma; UC: Unclassified, y: years.
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2021 ASCO Annual Meeting
First Author: Mobeen Zaka Haider
2023 ASCO Annual Meeting
First Author: Sylvain Choquet
2020 ASCO Virtual Scientific Program
First Author: Juan Garza
2021 ASCO Annual Meeting
First Author: Inna A. Kamaeva