Characteristics of T- and NK-cell Lymphomas After Renal Transplantation: A French National Multicentric Cohort Study

被引:3
|
作者
Barba, Thomas [1 ]
Bachy, Emmanuel [2 ,3 ]
Maarek, Alizee [4 ]
Fossard, Gaelle [2 ]
Genestier, Laurent [3 ]
Anglicheau, Dany [5 ,6 ]
Moal, Valerie [5 ,7 ]
Dantal, Jacques [5 ,8 ]
Rieu, Philippe [5 ,9 ]
Chemouny, Jonathan [5 ,10 ]
Charrier, Manon [5 ,11 ]
Durrbach, Antoine [5 ,12 ]
Provot, Francois [5 ,13 ]
Ducloux, Didier [5 ,14 ]
Westeel, Pierre-Francois [5 ,15 ]
Heng, Anne-Elisabeth [5 ,16 ]
Rerolle, Jean-Philippe [5 ,17 ]
Barrou, Benoit [5 ,18 ]
Grimbert, Philippe [5 ,19 ]
Chatelet, Valerie [5 ,20 ]
Mousson, Christiane [5 ,21 ]
Janbon, Benedicte [5 ,22 ]
Pernin, Vincent [5 ,23 ]
Frimat, Luc [24 ]
Ouali, Nacera [5 ,25 ]
Glotz, Denis [5 ,26 ]
Thierry, Antoine [5 ,27 ]
Mariat, Christophe [5 ,28 ]
Buchler, Mathias [5 ,29 ]
Gaulard, Philippe [30 ]
Leblond, Veronique [31 ]
Morelon, Emmanuel [1 ,4 ]
Dubois, Valerie [32 ]
Salles, Gilles [2 ,3 ]
Caillard, Sophie [5 ,33 ]
Thaunat, Olivier [1 ,4 ]
机构
[1] CIRI, INSERM U1111, Lyon, France
[2] Univ Lyon, Dept Hematol, HCL Ctr Hospitalier Lyon Sud, Lyon, France
[3] CRCL, INSERM U1052, Pierre Benite, France
[4] Univ Lyon, Dept Transplantat Nephrol & Clin Immunol, HCL Hop Edouard Herriot, Lyon, France
[5] Univ Hosp Strasbourg, French PTLD Registry, Strasbourg, France
[6] Hop Necker Enfants Malad, AP HP, Renal Transplantat Dept, Paris, France
[7] Hop Conception, AP HM, Dept Nephrol, Marseille, France
[8] Hop Hotel Dieu, Dept Nephrol & Transplantat, Nantes, France
[9] Univ Hosp, Nephrol Dept, Transplant Unit, Reims, France
[10] Univ Hosp, Dept Nephrol, Transplant Unit, Rennes, France
[11] Bordeaux Univ Hosp, Dept Nephrol Transplantat Dialysis & Apheresis, Bordeaux, France
[12] AP HP, Dept Nephrol & Transplantat, Le Kremlin Bicetre, France
[13] Univ Hosp, Nephrol Dept, Transplant Unit, Lille, France
[14] Besancon Univ Hosp, Nephrol Dept, Transplant Unit, Besancon, France
[15] Univ Hosp, Nephrol Dept, Transplant Unit, Amiens, France
[16] CHU Clermont Ferrand, Nephrol Dept, Clermont Ferrand, France
[17] Dupuytren Hosp, Dept Nephrol, Limoges, France
[18] Hop La Pitie Salpetriere, AP HP, Dept Urol Nephrol & Transplantat, Paris, France
[19] Grp Hospitalier Henri Mondor, AP HP, Dept Nephrol & Renal Transplantat, Creteil, France
[20] CHU Caen, Nephrol Dept, Caen, France
[21] Dijon Univ Hosp, Nephrol Dept, Transplant Unit, Dijon, France
[22] Univ Hosp, Dept Nephrol, Grenoble, France
[23] Lapeyronie Univ Hosp, Dept Nephrol Dialysis & Transplantat, Montpellier, France
[24] Nancy Univ Hosp, Nephrol Dept, Transplant Unit, Nancy, France
[25] Tenon Hosp, AP HP, Urgences Nephrol & Transplantat Renale, Paris, France
[26] St Louis Hosp, AP HP, Dept Nephrol & Transplantat, Paris, France
[27] CHU Poitiers, Dept Nephrol Dialysis & Kidney Transplantat, Poitiers, France
[28] CHU St Etienne, Hop Nord, Nephrol Dialysis & Renal Transplantat Dept, St Etienne, France
[29] CHRU Tours, Nephrol Dialysis & Renal Transplantat Dept, Tours, France
[30] Univ Paris Est, Dept Pathol, INSERM, Hop Henri Mondor,APHP,U955, Creteil, France
[31] Hop La Pitie Salpetriere, AP HP, Dept Hematol, Paris, France
[32] Etab Francais Sang, Lyon, France
[33] Univ Hosp Strasbourg, Dept Nephrol & Transplantat, Strasbourg, France
关键词
POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER; EPSTEIN-BARR-VIRUS; IMMUNOSUPPRESSIVE DRUGS; INITIAL THERAPY; REDUCTION; PROGNOSIS; SURVIVAL; REGISTRY; GRAFT;
D O I
10.1097/TP.0000000000003568
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Posttransplant lymphoproliferative disorders (PTLDs) encompass a spectrum of heterogeneous entities. Because the vast majority of cases PTLD arise from B cells, available data on PTLD of T or NK phenotype (T/NK-cell PTLD) are scarce, which limits the quality of the management of these patients. Methods. All adult cases of PTLD diagnosed in France were prospectively recorded in the national registry between 1998 and 2007. Crosschecking the registry data with 2 other independent national databases identified 58 cases of T/NK-cell PTLD. This cohort was then compared with (i) the 395 cases of B-cell PTLD from the registry, and of (ii) a cohort of 148 T/NK-cell lymphomas diagnosed in nontransplanted patients. Results. T/NK-cell PTLD occurred significantly later after transplantation and had a worse overall survival than B-cell PTLD. Two subtypes of T/NK-cell PTLD were distinguished: (i) cutaneous (28%) and (ii) systemic (72%), the latter being associated with a worse prognosis. Compared with T/NK-cell lymphomas of nontransplanted patients, overall survival of systemic T/NK-cell PTLD was worse (hazard ratio: 2.64 [1.76-3.94]; P < 0.00001). Conclusions. This difference, which persisted after adjustment on tumoral mass, histological subtype, and extension of the disease at diagnosis could be explained by the fact that transplanted patients were less intensively treated and responded less to chemotherapy.
引用
收藏
页码:1858 / 1868
页数:11
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