Management of lymphoproliferative disorders after cardiac transplantation

Jonathan M. Chen, Mark L. Barr, Amy Chadburn, Glauco Frizzera, Felicia A. Schenkel, Robert R. Sciacca, Dennis S. Reison, Linda J. Addonizio, Eric A. Rose, Daniel M. Knowles, Robert E. Michler

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

We conducted a retrospective study of 516 cardiac recipients who underwent transplantation between April 1983 and April 1992, 19 of whom had development of posttransplantation lymphoproliferative disorders (PTLDs). These 19 patients presented with involvement of lung (5), gastrointestinal tract (5), disseminated disease (6), and adenoids and lymph nodes (3). B-cell proliferations ranging from an atypical hyperplasia to malignant lymphoma developed in 18 patients, and mixed cellularity Hodgkin's disease developed in 1 patient. The 19 patients with PTLD displayed a predominance of both women and cardiomyopathy as the indication for transplantation when compared with two separate control populations. No correlation was found between demographic criteria analyzed and (1) early versus late diagnosis of PTLD after transplantation, (2) the site of PTLD involvement, or (3) the histopathologic category of the PTLD lesion. Patients with gastrointestinal tract and lung PTLD involvement enjoyed an improved survival after both transplantation and PTLD diagnosis when compared with patients with PTLD involvement of all other extranodal sites. We report a high incidence of PTLD involving the lung and gastrointestinal tract in our cohort study. These sites of involvement responded better to a reduction in immunosuppression than did the other extranodal sites of involvement.

Original languageEnglish (US)
Pages (from-to)527-538
Number of pages12
JournalThe Annals of thoracic surgery
Volume56
Issue number3
DOIs
StatePublished - 1993
Externally publishedYes

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Lymphoproliferative Disorders
Heart Transplantation
Transplantation
Gastrointestinal Tract
Lung
Adenoids
Delayed Diagnosis
Hodgkin Disease
Cardiomyopathies
Immunosuppression
Hyperplasia
Lymphoma
B-Lymphocytes
Cohort Studies
Retrospective Studies
Lymph Nodes
Cell Proliferation
Demography
Survival
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Chen, J. M., Barr, M. L., Chadburn, A., Frizzera, G., Schenkel, F. A., Sciacca, R. R., ... Michler, R. E. (1993). Management of lymphoproliferative disorders after cardiac transplantation. The Annals of thoracic surgery, 56(3), 527-538. https://doi.org/10.1016/0003-4975(93)90893-M

Management of lymphoproliferative disorders after cardiac transplantation. / Chen, Jonathan M.; Barr, Mark L.; Chadburn, Amy; Frizzera, Glauco; Schenkel, Felicia A.; Sciacca, Robert R.; Reison, Dennis S.; Addonizio, Linda J.; Rose, Eric A.; Knowles, Daniel M.; Michler, Robert E.

In: The Annals of thoracic surgery, Vol. 56, No. 3, 1993, p. 527-538.

Research output: Contribution to journalArticle

Chen, JM, Barr, ML, Chadburn, A, Frizzera, G, Schenkel, FA, Sciacca, RR, Reison, DS, Addonizio, LJ, Rose, EA, Knowles, DM & Michler, RE 1993, 'Management of lymphoproliferative disorders after cardiac transplantation', The Annals of thoracic surgery, vol. 56, no. 3, pp. 527-538. https://doi.org/10.1016/0003-4975(93)90893-M
Chen, Jonathan M. ; Barr, Mark L. ; Chadburn, Amy ; Frizzera, Glauco ; Schenkel, Felicia A. ; Sciacca, Robert R. ; Reison, Dennis S. ; Addonizio, Linda J. ; Rose, Eric A. ; Knowles, Daniel M. ; Michler, Robert E. / Management of lymphoproliferative disorders after cardiac transplantation. In: The Annals of thoracic surgery. 1993 ; Vol. 56, No. 3. pp. 527-538.
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