TY - JOUR
T1 - Decreased survival in hepatitis C patients with monomorphic post-transplant lymphoproliferative disorder after liver transplantation treated with frontline immunochemotherapy
AU - Alderuccio, Juan Pablo
AU - Stefanovic, Alexandra
AU - Dammrich, Daniel
AU - Chapman, Jennifer R.
AU - Vega, Francisco
AU - Selvaggi, Gennaro
AU - Tzakis, Andreas
AU - Lossos, Izidore S.
N1 - Funding Information:
Izidore S. Lossos, I. S. L., is supported by the Sylvester Comprehensive Cancer Center and by the Dwoskin, Recio and Anthony Rizzo Family Foundation.
Publisher Copyright:
© 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/9/2
Y1 - 2018/9/2
N2 - Post-transplant lymphoproliferative disorder (PTLD) develops in 1–3% of liver transplant recipients and no consensus exists about therapeutic management. From 2006 to 2016, 1489 liver transplants were performed at our institution with 20 patients (incidence 1.3%) developing PTLD. Hepatitis C virus (HCV) was the leading cause (n = 10) of liver transplant in PTLD patients. Diffuse large B-cell lymphoma was the most frequent histologic subtype (n = 17), and we report our experience in the management of these patients. Patients were treated with frontline immunochemotherapy without immunosuppression reduction. All evaluable patients achieved a complete remission. Statistically significant decreased survival was identified in HCV-positive patients. Six patients (60%) exhibited increases in HCV RNA levels during therapy. Four patients (40%) developed graft failure and three of them (30%) died from liver dysfunction. This is the first study providing evidence of decreased survival in HCV-positive PTLD patients after liver transplant receiving immunochemotherapy.
AB - Post-transplant lymphoproliferative disorder (PTLD) develops in 1–3% of liver transplant recipients and no consensus exists about therapeutic management. From 2006 to 2016, 1489 liver transplants were performed at our institution with 20 patients (incidence 1.3%) developing PTLD. Hepatitis C virus (HCV) was the leading cause (n = 10) of liver transplant in PTLD patients. Diffuse large B-cell lymphoma was the most frequent histologic subtype (n = 17), and we report our experience in the management of these patients. Patients were treated with frontline immunochemotherapy without immunosuppression reduction. All evaluable patients achieved a complete remission. Statistically significant decreased survival was identified in HCV-positive patients. Six patients (60%) exhibited increases in HCV RNA levels during therapy. Four patients (40%) developed graft failure and three of them (30%) died from liver dysfunction. This is the first study providing evidence of decreased survival in HCV-positive PTLD patients after liver transplant receiving immunochemotherapy.
KW - Post-transplant lymphoproliferative disorder
KW - hepatitis C virus and immunochemotherapy
KW - liver transplant
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U2 - 10.1080/10428194.2017.1413187
DO - 10.1080/10428194.2017.1413187
M3 - Article
C2 - 29252057
AN - SCOPUS:85038380131
SN - 1042-8194
VL - 59
SP - 2096
EP - 2104
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 9
ER -