Eren Arslan DAVULCU, Hale BÜlBÜL, Yusuf ULUSOY, Nur Akad SOYER, DERYA DEMİR, NAZAN ÖZSAN, GÜNEŞ AK, Fahri ŞAHİN, Mahmut TÖBÜ, MURAT TOMBULOĞLU, Filiz VURAL, Güray SAYDAM

Solid Organ Transplantasyonu Sonrası Post-Transplant Lenfoproliferatif Hastalıklar: Tek Merkez Deneyimi

Amaç: Kliniğimizde solid organ transplantasyonu sonrası post-transplant lenfoproliferatif hastalık tanısı almış hastaların klinik bulgularını, laboratuar özelliklerini, genel ve progesyonsuz sağ kalımlarını değerlendirmeyi amaçladık. Yöntemler: Ocak 2000- Aralık 2018 yılları arasında solid organ transplantasynu sonrası post-transplant lenfoproliferatif hastalık tanısı alan hastalar retrospektif olarak incelendi. Hastaların cinsiyeti, transplantasyon oldukları yaş, lenfoproliferatif hastalık tanı yaşı, transplantasyon sonrası lenfoproliferatif hastalık tanısına kadar geçen süre, lenfoproliferatif hastalık için klinik prezentasyonları, tümör karakteristikleri, tanı anındaki laktat dehidrogenaz düzeyleri, immunsupresif tedavileri, lenfoproliferatif hastalık için aldıkları tedaviler ve bu tedavilere yanıtları, toplam ve olaysız sağ kalım değerlendirildi. Bulgular: On hastaya post-transplant lenfoproliferatif hastalık tanısı konmuştur. Hastaların 8’i böbrek, 2’si karaciğer transplantasyonu sonrası lenfoproliferatif hastalık tanısı almışlardır. 8 hastaya diffüz büyük B hücreli lenfoma, 2 hastaya toplam 3 kere Hodgkin lenfoma (1 hasta nüks etmiştir) tanısı konmuştur. 5 yıllık sağ kalım %90±9 ve olaysız sağ kalım 150,76±13,28 ay bulunmuştur. Sonuç: Erken dönemde septik nedenlerle kaybedilen bir hasta dışındaki hastalar hayatta ve remisyondadır. Çalışmamızın 5 yıllık sağ kalım oranının literatürde bildirilen birçok çalışmadan daha uzun olması tedavi başarısını göstermektedir.

Post-Transplant Lymphoproliferative Diseases After Solid Organ Transplantation: Single Center Experience

Objective: We aimed to evaluate the clinical findings, laboratory features, general and progression free survival of the patients diagnosed with post-transplant lymphoproliferative disease in our clinic. Method: Patients who were diagnosed with post-transplant lymphoproliferative disease after solid organ transplantation between January 2000 and December 2018 were retrospectively analysed. Age of patients, age of transplantation, age of diagnosis of lymphoproliferative disease, time until diagnosis of lymphoproliferative disease after transplantation, clinical presentations for lymphoproliferative disease, tumor characteristics, lactate dehydrogenase levels at diagnosis, immunosuppressive therapies, treatments for lymphoproliferative disease and their responses to these therapies, overall and progression free survival were evaluated. Results: 10 patients were diagnosed with post-transplant lymphoproliferative disease in our clinic. Eight of the patients were diagnosed as lymphoproliferative disease after kidney transplantation and 2 patients after liver transplantation. 8 patients were diagnosed with diffuse large B-cell lymphoma, 2 patients were diagnosed with Hodgkin's lymphoma 3 times (1 patient relapsed). 5-year survival was 90 ± 9% and event-free survival was 150.76 ± 13.28 months. Conclusion: Patients are in remission and alive except one patient who died because of septic complications in early transplant period. The 5-year survival rate of our study is longer than the many studies reported in the literature and it shows the success of the treatment.

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