Premium
Posttransplant t‐cell lymphoma. Report of three cases and a review of the literature
Author(s) -
Van Gorp Joost,
Doornewaard Heleen,
Verdonck Leo F.,
Klöpping Corinne,
Vos Pieter F.,
Van Tweel Jan G. Den
Publication year - 1994
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19940615)73:12<3064::aid-cncr2820731227>3.0.co;2-0
Subject(s) - lymphoma , medicine , transplantation , anaplastic large cell lymphoma , t cell lymphoma , pathology , t cell , t cell receptor , organ transplantation , large cell , monoclonal , immunology , monoclonal antibody , cancer , antibody , immune system , adenocarcinoma
Background. Although 14% of the malignant lymphomas after organ transplantation are reported to be T‐cell lymphomas, only a few cases are described in the literature. Methods. The authors presented three new cases. They summarized the clinical data and analyzed histologic and immunochemical findings. The presence of Epstein‐Barr virus (EBV) and human T‐cell lymphoma type 1 (HTLV‐1) were investigated. T‐cell receptor (TCR) rearrangement was analyzed by Southern blot technique in two cases. Results. Two of the three lymphomas developed after renal transplantation. One was a T‐cell lymphoma of pleomorphic medium‐sized cell type and the other was a T‐cell lymphoblastic lymphoma; the third T‐cell lymphoma was an anaplastic large cell (Ki‐1 positive) type that developed after heart transplantation. No association was established with EBV or HTLV‐1. A monoclonal TCR rearrangement was found in the two cases that were analyzed. A literature search revealed 22 other cases. Nineteen of the 22 reported cases were peripheral T‐cell lymphomas. Almost all lymphomas presented in extranodal sites. The time between diagnosis and organ transplantation seemed to be influenced by the type of immunosuppressive therapy. In five cases, EBV was detected in the tumor cells. A monoclonal T‐cell receptor rearrangement was found in eight cases and a polyclonal proliferation in one case. Response to therapy was variable, but often poor. Conclusions. The etiology of posttransplant T‐cell lymphomas remains unclear. Similarities with post‐transplant B‐cell proliferations are the predominant extranodal presentation and the finding that the time of occurrence is influenced by the type of immunosuppression. In contrast with posttransplant B‐cell proliferations, only a minority of the cases are associated with EBV. Most tumors appear to be monoclonal. Prognosis is generally poor, but tumor presentation with localized disease might have a somewhat better prognosis. Cancer 1994; 73:3064–72.