Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiactransplant recipients

Lode Swinnen, Maria R. Costanzo-Nordin, Susan G. Fisher, E. Jeanne O'Sullivan, Maryl R. Johnson, Alain L. Heroux, George J. Dizikes, Roque Pifarre, Richard I. Fisher

Research output: Contribution to journalArticle

Abstract

Background. A sudden increase in the incidence of post-transplantation lymphoproliferative disorder among the patients in our cardiac-transplantation program was temporally related to introduction of the immunosuppressive drug OKT3. This monoclonal antibody has come to be widely used in recent years both to prevent and to treat rejection after cardiac transplantation. Methods. In order to identify variables that predict the development of post-transplantation lymphoproliferative disorder, we analyzed retrospectively a series of 154 consecutive cardiac-transplant recipients at a single institution. Univariate analyses and multivariate analysis by logistic regression were performed. Results. Among 75 patients who did not receive OKT3, post-transplantation lymphoproliferative disorder developed in 1 (1.3 percent), as compared with 9 of 79 patients who received the drug (11.4 percent); the incidence among the OKT3-treated patients was ninefold higher (odds ratio, 9.5; 95 percent confidence interval, 1.6 to 54.7). According to multivariate analysis, the only factor significantly associated with the development of post-transplantation lymphoproliferative disorder was the use of OKT3 (P = 0.001). A significant increase in risk with increasing doses was also apparent: 4 of 65 patients who received a cumulative dose of 75 mg of OKT3 or less (6.2 percent) had post-transplantation lymphoproliferative disorder, whereas 5 of 14 patients who received more than 75 mg had the disorder (35.7 percent; P

Original languageEnglish (US)
Pages (from-to)1723-1728
Number of pages6
JournalNew England Journal of Medicine
Volume323
Issue number25
StatePublished - Dec 20 1990
Externally publishedYes

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Muromonab-CD3
Lymphoproliferative Disorders
Immunosuppression
Transplantation
Incidence
Heart Transplantation
Multivariate Analysis
Immunosuppressive Agents
Pharmaceutical Preparations
Logistic Models
Odds Ratio
Monoclonal Antibodies
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Swinnen, L., Costanzo-Nordin, M. R., Fisher, S. G., O'Sullivan, E. J., Johnson, M. R., Heroux, A. L., ... Fisher, R. I. (1990). Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiactransplant recipients. New England Journal of Medicine, 323(25), 1723-1728.

Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiactransplant recipients. / Swinnen, Lode; Costanzo-Nordin, Maria R.; Fisher, Susan G.; O'Sullivan, E. Jeanne; Johnson, Maryl R.; Heroux, Alain L.; Dizikes, George J.; Pifarre, Roque; Fisher, Richard I.

In: New England Journal of Medicine, Vol. 323, No. 25, 20.12.1990, p. 1723-1728.

Research output: Contribution to journalArticle

Swinnen, L, Costanzo-Nordin, MR, Fisher, SG, O'Sullivan, EJ, Johnson, MR, Heroux, AL, Dizikes, GJ, Pifarre, R & Fisher, RI 1990, 'Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiactransplant recipients', New England Journal of Medicine, vol. 323, no. 25, pp. 1723-1728.
Swinnen, Lode ; Costanzo-Nordin, Maria R. ; Fisher, Susan G. ; O'Sullivan, E. Jeanne ; Johnson, Maryl R. ; Heroux, Alain L. ; Dizikes, George J. ; Pifarre, Roque ; Fisher, Richard I. / Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiactransplant recipients. In: New England Journal of Medicine. 1990 ; Vol. 323, No. 25. pp. 1723-1728.
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AU - O'Sullivan, E. Jeanne

AU - Johnson, Maryl R.

AU - Heroux, Alain L.

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