Post-transplant lymphoproliferative disorders (PTLD) after renal transplantation: Management and evolution of seven cases among 1002 renal transplants in São Paulo, Brazil

Post-transplant lymphoproliferative disorders (PTLD) after renal transplantation: Management and evolution of seven cases among 1002 renal transplants in São Paulo, Brazil

Autor Colleoni, GWB Google Scholar
Oliveira, JSR Google Scholar
Borducchi, DMM Google Scholar
Fernandes, MACF Google Scholar
Da Silva, H. T. Google Scholar
Alves, A. C. Google Scholar
De Franco, M. F. Google Scholar
Kerbauy, J. Google Scholar
Pestana, JOM Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo We reported seven cases (0.7%) of PTLD among 1002 renal transplants performed at Renal Transplant Service from Hospital São Paulo - Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil, between 1976 and 1997. There were three male and four female patients with median age of 37 year-old. According to Ann Arbor staging system there were four localized extra-nodal intermediate-grade NHL, one disseminated low-grade NHL and two polyclonal lymphoid hyperplasia. Four patients received cadaveric, two received related and one received unrelated renal transplant. PTLD occurred after a median latency period of 36 months (ranging from 5 to 84 months). in situ hybridization for EBER1 was performed in five patients and molecular evidence of EBV was found in 3 cases (two DLCL and one lymphoplasmocytoid lymphoma). All patients were treated with immunosuppression withdrawal, four patients received anthracyclin-based chemotherapy for control of localized or systemic clonal disease and three were treated with resection of primary PTLD. Four of seven patients (57%) are in complete remission 11, 20, 25 and 79 months after PTLD onset. One patient lost follow-up and two patients died due to lymphoma relapse, respectively 4 and 10 months after completion of treatment. in conclusion, our experience with this small group of patients showed that: I) immunosuppression withdrawal is not necessarily associated with loss of renal transplant and can he used as the only treatment for polyclonal PTLD; 2) chemotherapy can simultaneously lead to clonal PTLD remission and periodic immunosuppression, avoiding graft rejection after immunosuppression withdrawal.
Palavra-chave PTLD
renal transplantation
treatment
Idioma Inglês
Data de publicação 2000-09-01
Publicado em Leukemia & Lymphoma. Reading: Harwood Acad Publ Gmbh, v. 39, n. 1-2, p. 145-150, 2000.
ISSN 1042-8194 (Sherpa/Romeo, fator de impacto)
Publicador Harwood Acad Publ Gmbh
Extensão 145-150
Fonte http://dx.doi.org/10.3109/10428190009053548
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000088904400015
Endereço permanente http://repositorio.unifesp.br/handle/11600/26381

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