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 language | English (US) |
|---|---|
| Pages (from-to) | 14-18 |
| Number of pages | 5 |
| Journal | Journal of Pediatric Hematology/Oncology |
| Volume | 23 |
| Issue number | 1 |
| DOIs | |
| State | Published - 2001 |
| Externally published | Yes |
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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 journal › Article
}
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 -