Posttransplant lymphoproliferative disease in children

Correlation of histology to clinical behavior

R. J. Hayashi, M. D. Kraus, A. L. Patel, C. Canter, A. H. Cohen, P. Hmiel, T. Howard, C. Huddleston, J. A. Lowell, Jr Mallory G., E. Mendeloff, J. Molleston, S. Sweet, M. R. DeBaun

Research output: Contribution to journalArticle

Abstract

Purpose: To determine whether the morphologic features of posttransplant lymphoproliferative disease (PTLD) correlated to a response to therapy. Patients and Methods: We reviewed our experience with PTLD in the pediatric population. We identified 32 patients with a total of 36 episodes of PTLD. The diagnosis was confirmed by tissue examination and classified according to the degree of monomorphic features of the lesion. Thirty-four of 36 episodes were managed with immunosuppression reduction, and the patients were assessed for their response to this strategy. Chemotherapy was used to treat 10 of 15 patients who had progressive disease, and their subsequent course was also analyzed. Results: Sixteen of 17 (94%) patients with polymorphic morphology responded to immunosuppression reduction compared with only 5 of 17 (29%) patients with monomorphic features (P <0.001). All of the patients with progressive disease who did not receive additional therapy died. Standard chemotherapy regimens for lymphoma were administered to 10 patients with progressive disease, with a high response rate (90%), durable remissions, and acceptable toxicity. Conclusions: We conclude that the morphologic characteristics of PTLD provide information to potentially help guide treatment strategies in the management of this disease. Standard chemotherapy regimens for malignant lymphoma appear to be a viable treatment option for patients with progressive disease, although further investigation is needed.

Original languageEnglish (US)
Pages (from-to)14-18
Number of pages5
JournalJournal of Pediatric Hematology/Oncology
Volume23
Issue number1
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Histology
Drug Therapy
Immunosuppression
Lymphoma
Therapeutics
Disease Management
Pediatrics
Population

Keywords

  • Histology
  • Pediatric
  • Posttransplant lymphoproliferative disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Oncology
  • Hematology

Cite this

Posttransplant lymphoproliferative disease in children : Correlation of histology to clinical behavior. / Hayashi, R. J.; Kraus, M. D.; Patel, A. L.; Canter, C.; Cohen, A. H.; Hmiel, P.; Howard, T.; Huddleston, C.; Lowell, J. A.; Mallory G., Jr; Mendeloff, E.; Molleston, J.; Sweet, S.; DeBaun, M. R.

In: Journal of Pediatric Hematology/Oncology, Vol. 23, No. 1, 2001, p. 14-18.

Research output: Contribution to journalArticle

Hayashi, RJ, Kraus, MD, Patel, AL, Canter, C, Cohen, AH, Hmiel, P, Howard, T, Huddleston, C, Lowell, JA, Mallory G., J, Mendeloff, E, Molleston, J, Sweet, S & DeBaun, MR 2001, 'Posttransplant lymphoproliferative disease in children: Correlation of histology to clinical behavior', Journal of Pediatric Hematology/Oncology, vol. 23, no. 1, pp. 14-18. https://doi.org/10.1097/00043426-200101000-00005
Hayashi, R. J. ; Kraus, M. D. ; Patel, A. L. ; Canter, C. ; Cohen, A. H. ; Hmiel, P. ; Howard, T. ; Huddleston, C. ; Lowell, J. A. ; Mallory G., Jr ; Mendeloff, E. ; Molleston, J. ; Sweet, S. ; DeBaun, M. R. / Posttransplant lymphoproliferative disease in children : Correlation of histology to clinical behavior. In: Journal of Pediatric Hematology/Oncology. 2001 ; Vol. 23, No. 1. pp. 14-18.
@article{d781a93cec1a4fe0afd395167a3616df,
title = "Posttransplant lymphoproliferative disease in children: Correlation of histology to clinical behavior",
abstract = "Purpose: To determine whether the morphologic features of posttransplant lymphoproliferative disease (PTLD) correlated to a response to therapy. Patients and Methods: We reviewed our experience with PTLD in the pediatric population. We identified 32 patients with a total of 36 episodes of PTLD. The diagnosis was confirmed by tissue examination and classified according to the degree of monomorphic features of the lesion. Thirty-four of 36 episodes were managed with immunosuppression reduction, and the patients were assessed for their response to this strategy. Chemotherapy was used to treat 10 of 15 patients who had progressive disease, and their subsequent course was also analyzed. Results: Sixteen of 17 (94{\%}) patients with polymorphic morphology responded to immunosuppression reduction compared with only 5 of 17 (29{\%}) patients with monomorphic features (P <0.001). All of the patients with progressive disease who did not receive additional therapy died. Standard chemotherapy regimens for lymphoma were administered to 10 patients with progressive disease, with a high response rate (90{\%}), durable remissions, and acceptable toxicity. Conclusions: We conclude that the morphologic characteristics of PTLD provide information to potentially help guide treatment strategies in the management of this disease. Standard chemotherapy regimens for malignant lymphoma appear to be a viable treatment option for patients with progressive disease, although further investigation is needed.",
keywords = "Histology, Pediatric, Posttransplant lymphoproliferative disease",
author = "Hayashi, {R. J.} and Kraus, {M. D.} and Patel, {A. L.} and C. Canter and Cohen, {A. H.} and P. Hmiel and T. Howard and C. Huddleston and Lowell, {J. A.} and {Mallory G.}, Jr and E. Mendeloff and J. Molleston and S. Sweet and DeBaun, {M. R.}",
year = "2001",
doi = "10.1097/00043426-200101000-00005",
language = "English (US)",
volume = "23",
pages = "14--18",
journal = "Journal of Pediatric Hematology/Oncology",
issn = "1077-4114",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Posttransplant lymphoproliferative disease in children

T2 - Correlation of histology to clinical behavior

AU - Hayashi, R. J.

AU - Kraus, M. D.

AU - Patel, A. L.

AU - Canter, C.

AU - Cohen, A. H.

AU - Hmiel, P.

AU - Howard, T.

AU - Huddleston, C.

AU - Lowell, J. A.

AU - Mallory G., Jr

AU - Mendeloff, E.

AU - Molleston, J.

AU - Sweet, S.

AU - DeBaun, M. R.

PY - 2001

Y1 - 2001

N2 - Purpose: To determine whether the morphologic features of posttransplant lymphoproliferative disease (PTLD) correlated to a response to therapy. Patients and Methods: We reviewed our experience with PTLD in the pediatric population. We identified 32 patients with a total of 36 episodes of PTLD. The diagnosis was confirmed by tissue examination and classified according to the degree of monomorphic features of the lesion. Thirty-four of 36 episodes were managed with immunosuppression reduction, and the patients were assessed for their response to this strategy. Chemotherapy was used to treat 10 of 15 patients who had progressive disease, and their subsequent course was also analyzed. Results: Sixteen of 17 (94%) patients with polymorphic morphology responded to immunosuppression reduction compared with only 5 of 17 (29%) patients with monomorphic features (P <0.001). All of the patients with progressive disease who did not receive additional therapy died. Standard chemotherapy regimens for lymphoma were administered to 10 patients with progressive disease, with a high response rate (90%), durable remissions, and acceptable toxicity. Conclusions: We conclude that the morphologic characteristics of PTLD provide information to potentially help guide treatment strategies in the management of this disease. Standard chemotherapy regimens for malignant lymphoma appear to be a viable treatment option for patients with progressive disease, although further investigation is needed.

AB - Purpose: To determine whether the morphologic features of posttransplant lymphoproliferative disease (PTLD) correlated to a response to therapy. Patients and Methods: We reviewed our experience with PTLD in the pediatric population. We identified 32 patients with a total of 36 episodes of PTLD. The diagnosis was confirmed by tissue examination and classified according to the degree of monomorphic features of the lesion. Thirty-four of 36 episodes were managed with immunosuppression reduction, and the patients were assessed for their response to this strategy. Chemotherapy was used to treat 10 of 15 patients who had progressive disease, and their subsequent course was also analyzed. Results: Sixteen of 17 (94%) patients with polymorphic morphology responded to immunosuppression reduction compared with only 5 of 17 (29%) patients with monomorphic features (P <0.001). All of the patients with progressive disease who did not receive additional therapy died. Standard chemotherapy regimens for lymphoma were administered to 10 patients with progressive disease, with a high response rate (90%), durable remissions, and acceptable toxicity. Conclusions: We conclude that the morphologic characteristics of PTLD provide information to potentially help guide treatment strategies in the management of this disease. Standard chemotherapy regimens for malignant lymphoma appear to be a viable treatment option for patients with progressive disease, although further investigation is needed.

KW - Histology

KW - Pediatric

KW - Posttransplant lymphoproliferative disease

UR - http://www.scopus.com/inward/record.url?scp=0035153094&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035153094&partnerID=8YFLogxK

U2 - 10.1097/00043426-200101000-00005

DO - 10.1097/00043426-200101000-00005

M3 - Article

VL - 23

SP - 14

EP - 18

JO - Journal of Pediatric Hematology/Oncology

JF - Journal of Pediatric Hematology/Oncology

SN - 1077-4114

IS - 1

ER -