PURPOSE: The objective of this study was to determine prognostic factors for overall survival in patients with post-transplantation lymphoproliferative disorders (PTLDs). PATIENTS AND METHODS: This study focused on the 107 adult solid organ transplantation patients who were diagnosed with PTLDs at Mayo Clinic (Rochester, MN) between December 1970 and May 2003. RESULTS: The median age at the time of diagnosis was 48 years (range, 15 to 75 years). Extranodal disease including grafted organ involvement was present in 85 patients (80%). The graft organ was involved in 30 patients (28%). At the time of these analyses, 62 patients (58%) had died. The median survival for the entire cohort was 31.5 months (95% CI, 10.7 to 72.5 months). The median follow-up of living patients was 51.8 months (range, 5.6 to 202.6 months). In univariate analyses for overall survival from the time of PTLD diagnosis, the following poor prognostic factors were identified: poor performance status with Eastern Cooperative Oncology Group levels 3 and 4 (P < .0001), grafted organ involvement (P = .0005), the presence of one or more extranodal sites (P = .005), both nodal and extranodal disease (P = .002), high International Prognostic Index (P = .006), advanced stage (P = .001), and elevated lactate dehydrogenase (P = .03). A final multivariable model for survival was constructed using three factors: poor performance status (3 to 4), monomorphic disease, and graft organ involvement. CONCLUSION: A prognostic model has been developed for PTLD patients using one center's 30 years of experience. We propose additional confirmation and validation of these prognostic factors in larger prospective studies.
PURPOSE: The objective of this study was to determine prognostic factors for overall survival in patients with post-transplantation lymphoproliferative disorders (PTLDs). PATIENTS AND METHODS: This study focused on the 107 adult solid organ transplantation patients who were diagnosed with PTLDs at Mayo Clinic (Rochester, MN) between December 1970 and May 2003. RESULTS: The median age at the time of diagnosis was 48 years (range, 15 to 75 years). Extranodal disease including grafted organ involvement was present in 85 patients (80%). The graft organ was involved in 30 patients (28%). At the time of these analyses, 62 patients (58%) had died. The median survival for the entire cohort was 31.5 months (95% CI, 10.7 to 72.5 months). The median follow-up of living patients was 51.8 months (range, 5.6 to 202.6 months). In univariate analyses for overall survival from the time of PTLD diagnosis, the following poor prognostic factors were identified: poor performance status with Eastern Cooperative Oncology Group levels 3 and 4 (P < .0001), grafted organ involvement (P = .0005), the presence of one or more extranodal sites (P = .005), both nodal and extranodal disease (P = .002), high International Prognostic Index (P = .006), advanced stage (P = .001), and elevated lactate dehydrogenase (P = .03). A final multivariable model for survival was constructed using three factors: poor performance status (3 to 4), monomorphic disease, and graft organ involvement. CONCLUSION: A prognostic model has been developed for PTLDpatients using one center's 30 years of experience. We propose additional confirmation and validation of these prognostic factors in larger prospective studies.
Authors: M R Luskin; D S Heil; K S Tan; S Choi; E A Stadtmauer; S J Schuster; D L Porter; R H Vonderheide; A Bagg; D F Heitjan; D E Tsai; R Reshef Journal: Am J Transplant Date: 2015-05-18 Impact factor: 8.086
Authors: Andrew M Evens; Kevin A David; Irene Helenowski; Beverly Nelson; Dixon Kaufman; Sheetal M Kircher; Alla Gimelfarb; Elise Hattersley; Lauren A Mauro; Borko Jovanovic; Amy Chadburn; Patrick Stiff; Jane N Winter; Jayesh Mehta; Koen Van Besien; Stephanie Gregory; Leo I Gordon; Jamile M Shammo; Scott E Smith; Sonali M Smith Journal: J Clin Oncol Date: 2010-01-19 Impact factor: 44.544