Post-Transplantation Lymphoproliferative Disorder After Kidney Transplantation: Report of a Nationwide French Registry and the Development of a New Prognostic Score
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Published:2013-04-01
Issue:10
Volume:31
Page:1302-1309
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ISSN:0732-183X
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Container-title:Journal of Clinical Oncology
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language:en
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Short-container-title:JCO
Author:
Caillard Sophie1, Porcher Raphael1, Provot François1, Dantal Jacques1, Choquet Sylvain1, Durrbach Antoine1, Morelon Emmanuel1, Moal Valérie1, Janbon Benedicte1, Alamartine Eric1, Pouteil Noble Claire1, Morel Delphine1, Kamar Nassim1, Buchler Matthias1, Mamzer Marie France1, Peraldi Marie Noelle1, Hiesse Christian1, Renoult Edith1, Toupance Olivier1, Rerolle Jean Philippe1, Delmas Sylvie1, Lang Philippe1, Lebranchu Yvon1, Heng Anne Elisabeth1, Rebibou Jean Michel1, Mousson Christiane1, Glotz Denis1, Rivalan Joseph1, Thierry Antoine1, Etienne Isabelle1, Moal Marie Christine1, Albano Laetitia1, Subra Jean François1, Ouali Nacera1, Westeel Pierre François1, Delahousse Michel1, Genin Robert1, Hurault de Ligny Bruno1, Moulin Bruno1
Affiliation:
1. Sophie Caillard and Bruno Moulin, Strasbourg University Hospital, Strasbourg; Raphael Porcher, Marie Noelle Peraldi, and Denis Glotz, Hôpital Saint-Louis; Sylvain Choquet, La Pitié; Marie France Mamzer, Hôpital Necker; Nacera Ouali, Hôpital Tenon, Paris; François Provot, University of Lille, Lille; Jacques Dantal, University of Nantes, Nantes; Antoine Durrbach and Christian Hiesse, University of Kremlin Bicêtre, Le Kremlin–Bicêtre; Emmanuel Morelon, Hôpital Edouard Herriot, University of Lyon; Claire...
Abstract
Purpose Post-transplantation lymphoproliferative disorder (PTLD) is associated with significant mortality in kidney transplant recipients. We conducted a prospective survey of the occurrence of PTLD in a French nationwide population of adult kidney recipients over 10 years. Patients and Methods A French registry was established to cover a nationwide population of transplant recipients and prospectively enroll all adult kidney recipients who developed PTLD between January 1, 1998, and December 31, 2007. Five hundred patient cases of PTLD were referred to the French registry. The prognostic factors for PTLD were investigated using Kaplan-Meier and Cox analyses. Results Patients with PTLD had a 5-year survival rate of 53% and 10-year survival rate of 45%. Multivariable analyses revealed that age > 55 years, serum creatinine level > 133 μmol/L, elevated lactate dehydrogenase levels, disseminated lymphoma, brain localization, invasion of serous membranes, monomorphic PTLD, and T-cell PTLD were independent prognostic indicators of poor survival. Considering five variables at diagnosis (age, serum creatinine, lactate dehydrogenase, PTLD localization, and histology), we constructed a prognostic score that classified patients with PTLD as being at low, moderate, high, or very high risk for death. The 10-year survival rate was 85% for low-, 80% for moderate-, 56% for high-, and 0% for very high–risk recipients. Conclusion This nationwide study highlights the prognostic factors for PTLD and enables the development of a new prognostic score. After validation in an independent cohort, the use of this score should allow treatment strategies to be better tailored to individual patients in the future.
Publisher
American Society of Clinical Oncology (ASCO)
Subject
Cancer Research,Oncology
Cited by
116 articles.
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