TY - JOUR
T1 - Prognostic factors in patients with post-transplant lymphoproliferative disorders (PTLD) in the rituximab era
AU - Ghobrial, Irene M.
AU - Habermann, Thomas M.
AU - Ristow, Kay M.
AU - Ansell, Stephen M.
AU - Macon, William
AU - Geyer, Suzan M.
AU - McGregor, Christopher G.
N1 - 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.
PY - 2005/2
Y1 - 2005/2
N2 - 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.
AB - 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.
KW - PTLD
KW - Prognostic factors
KW - Rituximab
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U2 - 10.1080/10428190400012011
DO - 10.1080/10428190400012011
M3 - Article
C2 - 15621801
AN - SCOPUS:13244249647
SN - 1042-8194
VL - 46
SP - 191
EP - 196
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 2
ER -