Journal
LEUKEMIA & LYMPHOMA
Volume 59, Issue 9, Pages 2096-2104Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/10428194.2017.1413187
Keywords
Post-transplant lymphoproliferative disorder; liver transplant; hepatitis C virus and immunochemotherapy
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Funding
- Sylvester Comprehensive Cancer Center
- Dwoskin, Recio and Anthony Rizzo Family Foundation
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Post-transplant lymphoproliferative disorder (PTLD) develops in 1-3% of liver transplant recipients and no consensus exists about therapeutic management. From 2006 to 2016, 1489 liver transplants were performed at our institution with 20 patients (incidence 1.3%) developing PTLD. Hepatitis C virus (HCV) was the leading cause (n=10) of liver transplant in PTLD patients. Diffuse large B-cell lymphoma was the most frequent histologic subtype (n=17), and we report our experience in the management of these patients. Patients were treated with frontline immunochemotherapy without immunosuppression reduction. All evaluable patients achieved a complete remission. Statistically significant decreased survival was identified in HCV-positive patients. Six patients (60%) exhibited increases in HCV RNA levels during therapy. Four patients (40%) developed graft failure and three of them (30%) died from liver dysfunction. This is the first study providing evidence of decreased survival in HCV-positive PTLD patients after liver transplant receiving immunochemotherapy.
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