Clinical analysis of posttransplant lymphoproliferative disorder in kidney transplant recipients and hematopoietic stem cell transplant recipients summary

Objective To provide theoretic rationales and clinical experience for post-transplant lymphoproliferative disorder (PTLD) by comparing the characteristics of PTLD in kidney and hematopoietic stem cell transplant recipients and reviewing the relevant literature reports. Methods Twenty-seven adult PTLD patients from 2000 to 2017 were retrospectively reviewed. There were 11 kidney transplant recipients (KT group) and 16 hematopoietic stem cell transplant recipients (HSCT group). Clinical characteristics and outcomes were analyzed between two groups. Cox’s proportional hazard model was utilized for evaluating the prognostic factors. Results The incidence of PTLD for KT and HSCT groups were 0.5 % and 1.1 % respectively. PTLD patients of KT group had a later onset than that of HSCT group (105.1 vs 3.1 months, P<0.01). Also Epstein-Barr virus was less frequently detected in KT group (36.4 % vs 81.3 %, P<0.05). The 5-year overall survival was (46.8%±10.5%). According to Cox analysis, application of antithymocyte globulin (ATG) and high ECOG scores were risk factors for a poor prognosis of PTLD. Conclusions Most cases of KT-PTLD have a late onset. In contrast, HSCT-PTLD has an earlier onset and a higher incidence of EBV infectious. And application of ATG and high ECOG scores are poor prognosis factors of PTLD. Key words: Kidney transplantation; Hematopoietic stem cell transplantation; Prognosis