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Posttransplant monomorphic Burkitt’s lymphoma: clinical characteristics and outcome of a multicenter series

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Abstract

Burkitt’s monomorphic posttransplant lymphoproliferative disorder (B-PTLD) is an uncommon subtype of PTLD. Owing to the paucity of this complication, clinical characteristics and outcome has not been fully described. Clinical characteristics and outcomes of 20 patients diagnosed with B-PTLD from 10 transplant centers belonging to the GEL/TAMO group were reviewed. Median time from transplant to B-PTLD was 7.2 years. All the cases fulfill the morphologic and genetic criteria of B-PTLD, whereas Epstein-Barr virus (EBV) was detected in 70% of cases. Patients were treated with different chemotherapy combinations, and three patients received upfront rituximab monotherapy. The great majority of patients receiving CHOP-like regimens attained a complete response (CR) (73%), similar to that obtained with dose-intensive chemotherapy (83% CR). In contrast, patients receiving upfront rituximab monotherapy required subsequent chemotherapy. Two patients (10%) died during treatment due to infection. The median progression-free survival and overall survival (OS) were 16 months and 139 months, respectively. When analyzing variables predicting for OS, we found that patients with bone marrow involvement had an adverse prognosis, with a median OS of 6 months (p = 0.008). In conclusion, B-PTLD is an uncommon complication usually associated with EBV infection and with an aggressive clinical course, particularly in patients with bone marrow involvement. High-dose chemoimmunotherapy obtained similar responses to R-CHOP, suggesting that R-CHOP could be an adequate alternative for these patients. In contrast, rituximab monotherapy does not seem to be effective enough to control the disease.

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Authors and Affiliations

  1. Department of Hematology, Vall d’Hebron Institute of Oncology (VHIO), University Hospital Vall d’Hebron, University Autònoma of Barcelona (UAB), Barcelona, Spain

    S. Bobillo, P. Abrisqueta, J. Montoro, A. López & F. Bosch

  2. Department of Hematology, Hospital del Mar, Barcelona, Spain

    B. Sánchez-González

  3. Department of Hematology, Hospital Clínic, Barcelona, Spain

    E. Giné

  4. Department of Hematology, Hospital Universitario y Politecnico La Fe, Valencia, Spain

    S. Romero

  5. Department of Hematology, Hospital de Salamanca, Salamanca, Spain

    M. Alcoceba

  6. Department of Hematology, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Spain

    E. González-Barca

  7. Department of Hematology, Hospital Marqués de Valdecilla, Santander, Spain

    S. González de Villambrosía

  8. Department of Hematology, ICO-IJC-University Hospital Germans Trias i Pujol, Badalona, Spain

    J. M. Sancho

  9. Department of Hematology, Hospital La Paz, Madrid, Spain

    P. Gómez

  10. Department of Hematology, Hospital Universitario Son Espases, Mallorca, Spain

    L. Bento

  11. Department of Pathology, Hospital Marqués de Valdecilla, Santander, Spain

    S. Montes

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  1. S. Bobillo
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Consortia

on behalf of the Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea (GEL/TAMO cooperative group)

Contributions

All the authors contributed to the writing, approval, and review of the manuscript.

Corresponding author

Correspondence to F. Bosch.

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Conflict of interest

Dr. Francesc Bosch disclosures:

Research support: Roche, Gilead, Janssen, Celgene, Novartis, Abbvie, Takeda Honoraria (speaker’s bureau and/or advisory board): Roche, Gilead, Janssen, Celgene, Abbvie, and Takeda.

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This study was approved by the ethical committee of the University Hospital Vall d’Hebron.

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Bobillo, S., Abrisqueta, P., Sánchez-González, B. et al. Posttransplant monomorphic Burkitt’s lymphoma: clinical characteristics and outcome of a multicenter series. Ann Hematol 97, 2417–2424 (2018). https://doi.org/10.1007/s00277-018-3473-8

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  • DOI: https://doi.org/10.1007/s00277-018-3473-8

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