Document Detail


Identification of prognostic factors in 61 patients with posttransplantation lymphoproliferative disorders.
MedLine Citation:
PMID:  11157030     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Prognostic studies of posttransplantation lymphoproliferative disorders (PTLDs) are hindered by the small number of cases at each transplant center. We analyzed prognostic factors and long-term outcome according to clinical manifestations, pathologic features, and treatment and investigated the prognostic value of the non-Hodgkin's lymphoma International Prognostic Index (IPI) in 61 patients with PTLD. PATIENTS AND METHODS: We studied 61 patients in two institutions who developed PTLD and analyzed factors influencing the complete remission and survival rates. RESULTS: In univariate analysis, factors predictive of failure to achieve complete remission were performance status (PS) > or = (P =.0001) and nondetection of Epstein-Barr virus (EBV) in the tumor (P =.01). Only a negative link with PS > or = 2 was observed in multivariate analysis. In univariate analysis, factors predictive of lower survival were PS > or = 2, the number of sites (one v > one), primary CNS localization, T-cell origin, monoclonality, nondetection of EBV, and treatment with chemotherapy. The IPI failed to identify a patient subgroup with better survival and was less predictive of the response rate than was a specific index using two risk factors (PS and number of involved sites), which defined three groups of patients: low-risk patients whose median survival time has not yet been reached, intermediate-risk patients with a median survival time of 34 months, and high-risk patients with a median survival time of 1 month. CONCLUSION: PS and the number of involved sites defined three risk groups in our population. The value of these prognostic factors needs to be confirmed in larger cohorts of patients treated in prospective multicenter studies.
Authors:
V Leblond; N Dhedin; M F Mamzer Bruneel; S Choquet; O Hermine; R Porcher; S Nguyen Quoc; F Davi; F Charlotte; R Dorent; B Barrou; J P Vernant; M Raphael; V Levy
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  19     ISSN:  0732-183X     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-03-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  772-8     Citation Subset:  IM    
Affiliation:
Département d'Hématologie, Hôpital Pitié-Salpétrière, Paris, France. veronique.leblond@psl.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Analysis of Variance
Epstein-Barr Virus Infections / complications
Female
Herpesvirus 4, Human
Humans
Immunosuppressive Agents / therapeutic use
Lymphoproliferative Disorders / drug therapy,  etiology*,  pathology,  virology
Male
Middle Aged
Organ Transplantation / adverse effects*
Predictive Value of Tests
Prognosis
Severity of Illness Index
Survival Rate
Treatment Outcome
Tumor Virus Infections
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents

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