Gerhard Opelz1, Bernd Döhler. 1. Department of Transplantation Immunology, University of Heidelberg, Im Neuenheimer Feld 305, D-61920 Heidelberg, Germany. gerhard.opelz@med.uni-heidelberg.de
Abstract
BACKGROUND: Posttransplant non-Hodgkin lymphoma is a rare complication but associated with high mortality. The extent to which human leukocyte antigen (HLA) mismatching influences the rate of posttransplant lymphoma has not been clarified. METHODS: Data on lymphomas occurring in the first 3 years posttransplant were analyzed among first kidney transplants from deceased donors performed between 1985 and 2007 and reported to the Collaborative Transplant Study. RESULTS: Of 152,728 patients included, 593 non-Hodgkin lymphomas were diagnosed. Cox multivariate regression analysis showed that HLA-A mismatches had no influence on the rate of lymphoma. One and two HLA-DR mismatches were associated with a hazard ratio (HR) of 1.21 (95% confidence interval 1.00-1.45, P=0.047) and 1.56 (95% confidence interval 1.21-1.99, P<0.001), respectively. For lymphoma of the kidney and central nervous system, HRs for two HLA-DR mismatches were 2.29 (P=0.007) and 2.17 (P=0.029), respectively. Two HLA-B mismatches were also significantly associated with lymphoma in the kidney (HR 2.82, P=0.009). CONCLUSION: Mismatches at the HLA-DR locus are a significant risk factor for posttransplant non-Hodgkin lymphoma, particularly in the kidney and central nervous system, whereas two HLA-B mismatches increase the risk for the development of lymphoma of the kidney.
BACKGROUND: Posttransplant non-Hodgkin lymphoma is a rare complication but associated with high mortality. The extent to which human leukocyte antigen (HLA) mismatching influences the rate of posttransplant lymphoma has not been clarified. METHODS: Data on lymphomas occurring in the first 3 years posttransplant were analyzed among first kidney transplants from deceased donors performed between 1985 and 2007 and reported to the Collaborative Transplant Study. RESULTS: Of 152,728 patients included, 593 non-Hodgkin lymphomas were diagnosed. Cox multivariate regression analysis showed that HLA-A mismatches had no influence on the rate of lymphoma. One and two HLA-DR mismatches were associated with a hazard ratio (HR) of 1.21 (95% confidence interval 1.00-1.45, P=0.047) and 1.56 (95% confidence interval 1.21-1.99, P<0.001), respectively. For lymphoma of the kidney and central nervous system, HRs for two HLA-DR mismatches were 2.29 (P=0.007) and 2.17 (P=0.029), respectively. Two HLA-B mismatches were also significantly associated with lymphoma in the kidney (HR 2.82, P=0.009). CONCLUSION: Mismatches at the HLA-DR locus are a significant risk factor for posttransplant non-Hodgkin lymphoma, particularly in the kidney and central nervous system, whereas two HLA-B mismatches increase the risk for the development of lymphoma of the kidney.
Authors: Shehnaz K Hussain; Solomon B Makgoeng; Matthew J Everly; Marc T Goodman; Otoniel Martínez-Maza; Lindsay M Morton; Christina A Clarke; Charles F Lynch; Jon Snyder; Ajay Israni; Bertram L Kasiske; Eric A Engels Journal: Transplantation Date: 2016-11 Impact factor: 5.385
Authors: Benjamin Savenkoff; Perrine Aubertin; Marc Ladriere; Cyril Hulin; Jacqueline Champigneulle; Luc Frimat Journal: J Med Case Rep Date: 2014-06-18
Authors: Maja Ølholm Vase; Eva Futtrup Maksten; Charlotte Strandhave; Esben Søndergaard; Knud Bendix; Stephen Hamilton-Dutoit; Claus Andersen; Michael Boe Møller; Søren Schwartz Sørensen; Jan Kampmann; Hans Eiskjær; Martin Iversen; Ilse Duus Weinreich; Bjarne Møller; Bente Jespersen; Francesco d'Amore Journal: Transplant Direct Date: 2015-08-11