Early- and late-onset posttransplant lymphoproliferative disorders among adult kidney and liver transplant recipients

Objectives Posttransplant lymphoproliferative disorder (PTLD) in solid organ transplant recipients has a high mortality and may present early (<2 years) or late (>= 2 years) posttransplantation. We investigated the clinical characteristics of early and late PTLD among kidney and liver transplant recipients. Methods Recipients, transplanted at Rigshospitalet, with PTLD development as adults from January 2010 to August 2020, were included. Clinical characteristics, laboratory parameters, and pathology of early and late PTLD were compared. Results Thirty-one PTLD cases were detected where 10 (32%) were early and 21 (68%) were late PTLD. EBV DNA in plasma was detected in 78% versus 28% in early and late PTLD (p = .037). None of the recipients with early PTLD and nine recipients with late PTLD (47%) had Ann Arbor stage IV at the time of their diagnosis (p = .006). Cyclophosphamid-Hydroxyrubicin-Oncovin-Prednisolon was used for treatment in 10 (48%) recipients with late PTLD (p = 0.032) only. There was no difference in mortality between the two groups. Conclusions Recipients with late PTLD had a lower prevalence of detectable EBV DNA in plasma, were diagnosed with more advanced disease, and were more frequently treated with chemotherapy compared to recipients with early PTLD.

Automated summary

Early and late PTLD show differences in clinical characteristics, laboratory parameters, and pathology. Recipients with late PTLD have a lower prevalence of detectable EBV DNA in plasma, are diagnosed with more advanced disease, and are more frequently treated with chemotherapy.