Non-Hodgkin lymphoma after liver and kidney transplantation in children. Experience from one center.
Adv Clin Exp Med
; 29(2): 197-202, 2020 Feb.
Article
em En
| MEDLINE
| ID: mdl-32154678
ABSTRACT
BACKGROUND:
Post-transplantation lymphoproliferative disorder (PTLD) is a complication of organ transplantation and a life-threatening condition. Children who underwent organ transplantation are at risk of developing lymphoproliferative disorders and, among them, non-Hodgkin lymphoma (NHL) is the most serious.OBJECTIVES:
The objective of this study was to describe the clinical course of NHL after liver and kidney transplantation. MATERIAL ANDMETHODS:
Retrospective analysis of medical records of children who underwent liver/kidney transplantation and developed NHL.RESULTS:
Nine children were identified, all girls, 6 after liver and 3 after kidney transplantations. Age at transplantation ranged from 1 year to 13 years (median 4 years), while age at lymphoma diagnosis from 4 to 17 years (median 12 years). Time from transplantation to lymphoma diagnosis ranged from 7 months to 12 years (median 9 years). All but 1 patient developed mature B-cell lymphoma, 4 children - diffuse large B-cell lymphoma (DLBCL), 2 children - Burkitt's lymphoma, 1 child - mature B-cell leukemia, 1 child - Burkitt-like lymphoma, while 1 patient was diagnosed with T-cell lymphoblastic lymphoma. High levels of Epstein-Barr virus (EBV) DNA were found in blood of 3 patients, and EBV in tissue samples was detected in 4 patients. Six patients presented with stage III and 2 with stage IV disease. Two patients had graft involvement. Three children received chemotherapy according to R-CHOP, 3 LMB protocol (2 with addition of rituximab), while 1 received CHOP and 5 courses of COP. T-cell lymphoma patient was treated with Euro-LB protocol. Six out of 8 treated patients are alive with a median follow-up of 6 years. Two children died from disease progression during treatment and 1 from cerebral herniation before starting therapy. All patients experienced at least 1 toxic episode of grade 3 and 4 according to Common Toxicity Criteria Adverse Event (CTCAE). Complications of chemotherapy were manageable and there were no transplanted organ failures.CONCLUSIONS:
Our study provides further data on the treatment and outcome of monomorphic PTLD and indicates that it is feasible to treat solid organ recipients with multiagent chemotherapy.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Linfoma não Hodgkin
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Transplante de Rim
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Transplante de Fígado
Tipo de estudo:
Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
Idioma:
En
Revista:
Adv Clin Exp Med
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Polônia