Incidence and Management of Posttransplantation Lymphoproliferative Disorder After Pediatric Solid Organ Transplantation: The Norwegian Experience.

IF 1.4 4区医学 Q3 PEDIATRICS

Pediatric Transplantation Pub Date : 2025-03-01 DOI:10.1111/petr.70040

Olav Sondre Skorge Aartun, Karen Henriette Hustveit, Monica Cheng Munthe-Kaas, Ann Christin Gjerstad, Anna Bjerre, Anniken Bjørnstad Østensen, Thomas Möller

{"title":"Incidence and Management of Posttransplantation Lymphoproliferative Disorder After Pediatric Solid Organ Transplantation: The Norwegian Experience.","authors":"Olav Sondre Skorge Aartun, Karen Henriette Hustveit, Monica Cheng Munthe-Kaas, Ann Christin Gjerstad, Anna Bjerre, Anniken Bjørnstad Østensen, Thomas Möller","doi":"10.1111/petr.70040","DOIUrl":null,"url":null,"abstract":"Background: Posttransplant lymphoproliferative disorder (PTLD) is a complication of solid organ transplantation (SOT) due to immunosuppression. In 2023, a pediatric PTLD register was established in Norway because of a perceived increase in the incidence of pediatric PTLD. This study aimed to analyze population-based data on the incidence and management of pediatric PTLD after SOT using the pediatric PTLD registry in Norway.Methods: This retrospective quality assurance study collected the data of pediatric patients with PTLD after SOT in Norway from January 1, 1995, to December 31, 2023. For comparison and calculation of incidence rates, SOT patients without PTLD required a minimum of 1 year posttransplant follow-up to be included.Results: A total of 457 patients underwent SOT (57% males) and 22 (4.8%) developed PTLD (73% males). The median age at transplant in the SOT and PTLD groups were 9.5 (interquartile range, 2.4-14.5) and 4.3 (1.1-12.5) years, respectively. Twenty patients with PTLD (91%) were Epstein-Barr virus naive at the time of transplantation. Eighteen (82%) and four (18%) patients developed early and late PTLD, respectively. Ten patients had monomorphic PTLD (45%). All patients received a reduction in immunosuppression, 15 received rituximab, and six required chemotherapy. Six patients (27%) died after PTLD, five of whom had active PTLD disease at the time of death. None of the patients experienced graft loss.Conclusions: Our findings regarding the incidence, EBV status, sex, and age at transplantation align with those of previous studies.","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 2","pages":"e70040"},"PeriodicalIF":1.4000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Transplantation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/petr.70040","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Posttransplant lymphoproliferative disorder (PTLD) is a complication of solid organ transplantation (SOT) due to immunosuppression. In 2023, a pediatric PTLD register was established in Norway because of a perceived increase in the incidence of pediatric PTLD. This study aimed to analyze population-based data on the incidence and management of pediatric PTLD after SOT using the pediatric PTLD registry in Norway.

Methods: This retrospective quality assurance study collected the data of pediatric patients with PTLD after SOT in Norway from January 1, 1995, to December 31, 2023. For comparison and calculation of incidence rates, SOT patients without PTLD required a minimum of 1 year posttransplant follow-up to be included.

Results: A total of 457 patients underwent SOT (57% males) and 22 (4.8%) developed PTLD (73% males). The median age at transplant in the SOT and PTLD groups were 9.5 (interquartile range, 2.4-14.5) and 4.3 (1.1-12.5) years, respectively. Twenty patients with PTLD (91%) were Epstein-Barr virus naive at the time of transplantation. Eighteen (82%) and four (18%) patients developed early and late PTLD, respectively. Ten patients had monomorphic PTLD (45%). All patients received a reduction in immunosuppression, 15 received rituximab, and six required chemotherapy. Six patients (27%) died after PTLD, five of whom had active PTLD disease at the time of death. None of the patients experienced graft loss.

Conclusions: Our findings regarding the incidence, EBV status, sex, and age at transplantation align with those of previous studies.

查看原文本刊更多论文

儿童实体器官移植后淋巴增生性疾病的发病率和治疗：挪威的经验。

背景：移植后淋巴细胞增生性疾病（PTLD）是实体器官移植（SOT）术后由于免疫抑制引起的并发症。2023年，由于儿科PTLD发病率的增加，挪威建立了儿科PTLD登记册。本研究旨在利用挪威儿科PTLD注册表分析SOT后儿科PTLD发病率和管理的基于人群的数据。方法：本回顾性质量保证研究收集了1995年1月1日至2023年12月31日挪威SOT后PTLD患儿的资料。为了比较和计算发病率，没有PTLD的SOT患者需要移植后至少1年的随访。结果：共有457例患者接受了SOT（男性57%），22例（4.8%）发生了PTLD（男性73%）。SOT组和PTLD组移植时的中位年龄分别为9.5岁（四分位数范围2.4-14.5）和4.3岁（1.1-12.5）。20例PTLD患者（91%）在移植时未感染eb病毒。18例（82%）和4例（18%）患者分别发展为早期和晚期PTLD。单纯性PTLD 10例（45%）。所有患者均接受免疫抑制治疗，15例接受利妥昔单抗治疗，6例需要化疗。6名患者（27%）在PTLD后死亡，其中5名患者在死亡时患有活动性PTLD疾病。没有患者出现移植物丢失。结论：我们关于移植患者的发病率、EBV状态、性别和年龄的研究结果与之前的研究一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pediatric Transplantation 医学-小儿科

CiteScore

2.90

自引率

15.40%

发文量

216

审稿时长

3-8 weeks

期刊介绍： The aim of Pediatric Transplantation is to publish original articles of the highest quality on clinical experience and basic research in transplantation of tissues and solid organs in infants, children and adolescents. The journal seeks to disseminate the latest information widely to all individuals involved in kidney, liver, heart, lung, intestine and stem cell (bone-marrow) transplantation. In addition, the journal publishes focused reviews on topics relevant to pediatric transplantation as well as timely editorial comment on controversial issues.