Decreased survival in hepatitis C patients with monomorphic post-transplant lymphoproliferative disorder after liver transplantation treated with frontline immunochemotherapy

Juan Pablo Alderuccio, Alexandra Stefanovic, Daniel Dammrich, Jennifer R. Chapman, Francisco Vega, Gennaro Selvaggi, Andreas Tzakis, Izidore S. Lossos

Research output: Contribution to journalArticlepeer-review

Abstract

Post-transplant lymphoproliferative disorder (PTLD) develops in 1–3% of liver transplant recipients and no consensus exists about therapeutic management. From 2006 to 2016, 1489 liver transplants were performed at our institution with 20 patients (incidence 1.3%) developing PTLD. Hepatitis C virus (HCV) was the leading cause (n = 10) of liver transplant in PTLD patients. Diffuse large B-cell lymphoma was the most frequent histologic subtype (n = 17), and we report our experience in the management of these patients. Patients were treated with frontline immunochemotherapy without immunosuppression reduction. All evaluable patients achieved a complete remission. Statistically significant decreased survival was identified in HCV-positive patients. Six patients (60%) exhibited increases in HCV RNA levels during therapy. Four patients (40%) developed graft failure and three of them (30%) died from liver dysfunction. This is the first study providing evidence of decreased survival in HCV-positive PTLD patients after liver transplant receiving immunochemotherapy.

Original languageEnglish (US)
Pages (from-to)2096-2104
Number of pages9
JournalLeukemia and Lymphoma
Volume59
Issue number9
DOIs
StatePublished - Sep 2 2018

Keywords

  • Post-transplant lymphoproliferative disorder
  • hepatitis C virus and immunochemotherapy
  • liver transplant

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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