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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 (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 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 Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted September 8, 2008 Accepted February 21, 2009 Risk factors for lymphoproliferative disorders after allogeneic hematopoietic cell transplantation Ola Landgren*, Ethel S. Gilbert, J. Douglas Rizzo, Gerard Socie, Peter M. Banks, Kathleen A. Sobocinski, Mary M. Horowitz, Elaine S. Jaffe, Douglas W. Kingma, Lois B. Travis, Mary E. Flowers, Paul J. Martin, H. Joachim Deeg, and Rochelle E. Curtis Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States Hospital Saint Louis, Paris, France Carolinas Medical Center, Charlotte, NC, United States Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States University of Rochester, Department of Radiation Oncology, Rochester, NY, United States Fred Hutchinson Cancer Research Center, Seattle, WA, United States * Corresponding author; email: landgreo{at}mail.nih.gov. We evaluated 26,901 patients who underwent allogeneic hematopoietic cell transplantation (HCT) at 271 centers worldwide to define patterns of post-transplant lymphoproliferative disorders (PTLD). PTLD developed in 127 recipients, with 105 (83%) cases occurring within 1 year post-transplant. In multivariate analyses, we confirmed that PTLD risks were strongly associated (P<0.001) with T-cell depletion of the donor marrow, anti-thymocyte 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-mismatch donors (RR=3.8) was limited to patients with T-cell depletion or ATG use (P=0.004). New findings were elevated risks for age >50 years at transplant (RR=5.1;P<0.001) and second transplantation (RR=3.5;P<0.001). Lower risks were found for T-cell depletion methods that remove both T- and B-cells (CAMPATH-1 and elutriation, RR=3.1;P=0.025) compared with other methods (RR=9.4;P=0.005 for difference). The cumulative incidence of PTLD 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 >3 major risk factors, respectively. Our findings identify subgroups of allogeneic HCT recipients at elevated risk of PTLD 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]

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