Prognostic factors in patients with post-transplant lymphoproliferative disorders (PTLD) in the rituximab era

Irene M. Ghobrial, Thomas M. Habermann, Kay M. Ristow, Stephen M. Ansell, William Macon, Suzan M. Geyer, Christopher G. McGregor

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66 Scopus citations

Abstract

To assess the effect of rituximab therapy and other prognostic factors on overall survival in patients with post-transplant lymphoproliferative disorders (PTLD) after solid organ transplantation, 30 consecutive patients diagnosed with PTLD between 1999 and 2002 were analyzed. Fifteen (50%) patients received rituximab (375 mg/m2 once a week). Fifteen (50%) patients had other interventions including observation, immunosuppression reduction, surgery, chemotherapy, radiation or a combination of these. Patients receiving rituximab vs. non-rituximab differed in the following variables: age at diagnosis of PTLD (P=0.009), days to PTLD (P=0.0005), Epstein-Barr virus (EBV) in situ hybridization status (P=0.02) and CD20-positive status (P=0.006). At the time of last follow-up, 10 (33%) patients in the rituximab group and 5 (17%) in the non-rituximab group were alive. On univariate analysis for overall survival of all 30 patients, the significant factors were: treatment with rituximab (P=0.03), response to treatment (P=0.005), CD20 positive (P=0.0004), low international prognostic index (IPI; P=0.02) and good performance status (P=0.009). Multivariate analysis of all patients was significant for CD20-positive status (P=0.0007) and low performance status (P=0.006). On multivariate analysis for overall survival in patients with CD20-positive PTLD, low IPI (P=0.004) and rituximab therapy (P=0.03) were significant. Low IPI and rituximab therapy led to an improved overall survival in patients with CD20-positive PTLD.

Original languageEnglish (US)
Pages (from-to)191-196
Number of pages6
JournalLeukemia and Lymphoma
Volume46
Issue number2
DOIs
StatePublished - Feb 2005
Externally publishedYes

Bibliographical note

Funding Information:
IMG is supported in part by CA97274, the Multiple Myeloma Research Foundation, the ASCO Young Investigator Award and the Research Fund for Waldenstrom.

Keywords

  • PTLD
  • Prognostic factors
  • Rituximab

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