Kidney transplantationMalignancyPosttransplant Lymphoproliferative Disorder: Significance of Central Nervous System Involvement
Section snippets
Methods
Nine hundred ten PTLD cases from the USA were reported to the Israel Penn International Transplant Tumor Registry (IPITTR) and were reviewed for CNS involvement. Data analyzed included patient demographics, tumor characteristics, PTLD therapy and patient survival. Statistical analysis included, chi-square and student's t tests.
Results
One hundred thirty-six solid organ transplant recipients with PTLD (15%) had CNS involvement. By organ transplanted, the highest incidence of CNS involvement occurred in pancreas transplant recipients (3 of 11; 27%), followed by those with kidney (76 of 429; 18%), heart (37 of 296; 13%), liver (16 of 142; 11%), and lung transplants (4 of 32; 13%). The incidence of CNS involvement in pancreas transplant patients with PTLD was higher than in other solid organ transplant recipients (P < .01).
Discussion
PTLD itself is a serious complication, with significant mortality rates in all solid organ transplant recipients. However, the current analysis indicates that possibly the worst prognosis may occur in patients with CNS involvement, particularly when present with extracranial PTLD disease. The observation of higher rates in pancreas transplant patients was unexpected, and there are no obvious reasons to explain why they are prone to CNS involvement. A few factors did indicate a better prognosis,
Reference (1)
- et al.
Primary central nervous system posttransplant lymphoproliferative disorders
Am J Clin Pathol
(2004)
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