eISSN: 1644-4124
ISSN: 1426-3912
Central European Journal of Immunology
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4/2020
vol. 45
 
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abstract:
Case report

Post-transplant lymphoproliferative disorder in adult renal transplant recipients: case series and review of literature

Dorota Kamińska
1
,
Magdalena Krajewska
1
,
Oktawia Mazanowska
1
,
Paweł Poznański
1
,
Maria Boratyńska
2
,
Marian Klinger
3

  1. Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
  2. Faculty of Natural Sciences and Technology, Karkonosze College, Jelenia Gora, Poland
  3. Department of Nephrology, Institute of Medicine, University of Opole, Opole, Poland
Centr Eur J Immunol 2020; 45 (4): 498-506
DOI: https://doi.org/10.5114/ceji.2020.103427
Online publish date: 2021/01/30
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Post-transplant lymphoproliferative disorder (PTLD) is serious life-threating complication of transplantation. The clinical picture differs from lymphomas observed in the general population, with different

manifestation, histopathology, higher aggressiveness with involvement of sites beyond the primary lymph node, and poorer outcome.

The objective of the study was to present nine cases of PTLD observed in our centre among the kidney transplant recipient population and discuss the results with up-to-date literature. We performed a retrospective single-centre assessment of PTLD incidence in the cohorts of kidney transplant recipients followed by our centre. We found nine cases of PTLD, five men and four woman, aged from 26 to 67 years at the time of diagnosis (mean [SD] 48 [5] years), transplanted between 1997 and 2013.

The disease was diagnosed between 2002 and 2017, from 6 to 440 months after transplantation (mean [SD] 96 [137] months). A diffuse large B-cell lymphoma was found in seven cases early as well as late after transplantation, and two patients presented T-cell lymphoma. Five patients achieved complete remission with no relapses after 6 to 13 months of treatment. In three cases the remission was achieved by switching to mammalian target of rapamycin inhibitors (mTORi) only. Four recipients died from

2 weeks to 15 months after PTLD was diagnosed.

Although the diagnostic criteria of different forms of PTLD are commonly known, rapid and correct diagnosis is not easy. PTLD is a relatively a rare disease, so there are too few studies and little consensus on the optimal treatment.
keywords:

lymphoma, post-transplant lymphoproliferative disease, kidney transplantation
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