SEARCH:   Advanced

Blood, 14 May 2009, Vol. 113, No. 20, pp. 4992-5001. Prepublished online as a Blood First Edition Paper on March 5, 2009; DOI 10.1182/blood-2008-09-178046. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-09-178046v1 113/20/4992    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Landgren, O. Articles by Curtis, R. E. Search for Related Content PubMed PubMed Citation Articles by Landgren, O. Articles by Curtis, R. E. Related Collections Transplantation Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Risk factors for lymphoproliferative disorders after allogeneic hematopoietic cell transplantation Ola Landgren1,2, Ethel S. Gilbert1, J. Douglas Rizzo3, Gérard Socié4, Peter M. Banks5, Kathleen A. Sobocinski3, Mary M. Horowitz3, Elaine S. Jaffe6, Douglas W. Kingma6, Lois B. Travis7, Mary E. Flowers8, Paul J. Martin8, H. Joachim Deeg8, and Rochelle E. Curtis1 1 Division of Cancer Epidemiology and Genetics and 2 Medical Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Bethesda, MD; 3 Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee; 4 Hospital Saint Louis, Paris, France; 5 Carolinas Medical Center, Charlotte, NC; 6 Laboratory of Pathology, Center for Cancer Research, NCI, NIH, HHS, Bethesda, MD; 7 Department of Radiation Oncology, University of Rochester, NY; and 8 Fred Hutchinson Cancer Research Center, Seattle, WA We evaluated 26 901 patients who underwent allogeneic hematopoietic cell transplantation (HCT) at 271 centers worldwide to define patterns of posttransplantation lymphoproliferative disorders (PTLDs). PTLDs developed in 127 recipients, with 105 (83%) cases occurring within 1 year after transplantation. In multivariate analyses, we confirmed that PTLD risks were strongly associated (P < .001) with T-cell depletion of the donor marrow, antithymocyte globulin (ATG) use, and unrelated or HLA-mismatched grafts (URD/HLA mismatch). Significant associations were also confirmed for acute and chronic graft-versus-host disease. The increased risk associated with URD/HLA-mismatched donors (RR = 3.8) was limited to patients with T-cell depletion or ATG use (P = .004). New findings were elevated risks for age 50 years or older at transplantation (RR = 5.1; P < .001) and second transplantation (RR = 3.5; P < .001). Lower risks were found for T-cell depletion methods that remove both T and B cells (alemtuzumab and elutriation, RR = 3.1; P = .025) compared with other methods (RR = 9.4; P = .005 for difference). The cumulative incidence of PTLDs was low (0.2%) among 21 686 patients with no major risk factors, but increased to 1.1%, 3.6%, and 8.1% with 1, 2, and more than 3 major risk factors, respectively. Our findings identify subgroups of patients who underwent allogeneic HCT at elevated risk of PTLDs for whom prospective monitoring of Epstein-Barr virus activation and early treatment intervention may be particularly beneficial. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Does peritransplantation use of rituximab reduce the risk of EBV reactivation and PTLPD? Bipin N. Savani, Paula R. Pohlmann, Madan Jagasia, Wichai Chinratanalab, Adetola Kassim, Brian Engelhardt, John Greer, Friedrich Schuening, and Stacey Goodman Blood 2009 113: 6263-6264. [Full Text] [PDF] This article has been cited by other articles: B. N. Savani, P. R. Pohlmann, M. Jagasia, W. Chinratanalab, A. Kassim, B. Engelhardt, J. Greer, F. Schuening, and S. Goodman Does peritransplantation use of rituximab reduce the risk of EBV reactivation and PTLPD? Blood, June 11, 2009; 113(24): 6263 - 6264. [Full Text] [PDF]

	Copyright © 2009 by American Society of Hematology         Online ISSN: 1528-0020