PMID- 10498590
OWN - NLM
STAT- MEDLINE
DCOM- 19991104
LR  - 20211203
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 94
IP  - 7
DP  - 1999 Oct 1
TI  - Risk of lymphoproliferative disorders after bone marrow transplantation: a 
      multi-institutional study.
PG  - 2208-16
AB  - We evaluated 18,014 patients who underwent allogeneic bone marrow transplantation 
      (BMT) at 235 centers worldwide to examine the incidence of and risk factors for 
      posttransplant lymphoproliferative disorders (PTLD). PTLD developed in 78 
      recipients, with 64 cases occurring less than 1 year after transplantation. The 
      cumulative incidence of PTLD was 1.0% +/- 0.3% at 10 years. Incidence was highest 
      1 to 5 months posttransplant (120 cases/10,000 patients/yr) followed by a steep 
      decline to less than 5/10,000/yr among >/=1-year survivors. In multivariate 
      analyses, risk of early-onset PTLD (<1 year) was strongly associated (P <.0001) 
      with unrelated or human leukocyte antigen (HLA) mismatched related donor 
      (relative risk [RR] = 4.1), T-cell depletion of donor marrow (RR = 12.7), and use 
      of antithymocyte globulin (RR = 6.4) or anti-CD3 monoclonal antibody (RR = 43.2) 
      for prophylaxis or treatment of acute graft-versus-host disease (GVHD). There was 
      a weaker association with the occurrence of acute GVHD grades II to IV (RR = 1.9, 
      P =.02) and with conditioning regimens that included radiation (RR = 2.9, P 
      =.02). Methods of T-cell depletion that selectively targeted T cells or T plus 
      natural killer (NK) cells were associated with markedly higher risks of PTLD than 
      methods that removed both T and B cells, such as the CAMPATH-1 monoclonal 
      antibody or elutriation (P =.009). The only risk factor identified for late-onset 
      PTLD was extensive chronic GVHD (RR = 4.0, P =.01). Rates of PTLD among patients 
      with 2 or >/=3 major risk factors were 8.0% +/- 2.9% and 22% +/- 17.9%, 
      respectively. We conclude that factors associated with altered immunity and 
      T-cell regulatory mechanisms are predictors of both early- and late-onset PTLD.
FAU - Curtis, R E
AU  - Curtis RE
AD  - Division of Cancer Epidemiology, Laboratory of Pathology, National Cancer 
      Institute, Bethesda, MD, USA. curtisr@epndce.nci.nih.gov
FAU - Travis, L B
AU  - Travis LB
FAU - Rowlings, P A
AU  - Rowlings PA
FAU - Socie, G
AU  - Socie G
FAU - Kingma, D W
AU  - Kingma DW
FAU - Banks, P M
AU  - Banks PM
FAU - Jaffe, E S
AU  - Jaffe ES
FAU - Sale, G E
AU  - Sale GE
FAU - Horowitz, M M
AU  - Horowitz MM
FAU - Witherspoon, R P
AU  - Witherspoon RP
FAU - Shriner, D A
AU  - Shriner DA
FAU - Weisdorf, D J
AU  - Weisdorf DJ
FAU - Kolb, H J
AU  - Kolb HJ
FAU - Sullivan, K M
AU  - Sullivan KM
FAU - Sobocinski, K A
AU  - Sobocinski KA
FAU - Gale, R P
AU  - Gale RP
FAU - Hoover, R N
AU  - Hoover RN
FAU - Fraumeni, J F Jr
AU  - Fraumeni JF Jr
FAU - Deeg, H J
AU  - Deeg HJ
LA  - eng
GR  - P01-CA 18029/CA/NCI NIH HHS/United States
GR  - P01-CA-18221/CA/NCI NIH HHS/United States
GR  - P01-CA-40053/CA/NCI NIH HHS/United States
GR  - etc.
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Anemia, Aplastic/therapy
MH  - Bone Marrow Transplantation/*adverse effects/immunology
MH  - Child
MH  - Cohort Studies
MH  - Female
MH  - Graft vs Host Disease/prevention & control
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppression Therapy/methods
MH  - Immunosuppressive Agents/therapeutic use
MH  - Leukemia/therapy
MH  - Lymphocyte Depletion
MH  - Lymphoproliferative Disorders/*epidemiology
MH  - Male
MH  - Postoperative Complications/*epidemiology
MH  - Risk Factors
MH  - T-Lymphocytes/immunology
MH  - Transplantation, Homologous
MH  - United States/epidemiology
EDAT- 1999/09/25 09:00
MHDA- 2001/03/28 10:01
CRDT- 1999/09/25 09:00
PHST- 1999/09/25 09:00 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1999/09/25 09:00 [entrez]
AID - S0006-4971(20)71145-6 [pii]
PST - ppublish
SO  - Blood. 1999 Oct 1;94(7):2208-16.