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Incidence and Features of Lymphoid Proliferation and Lymphomas after Solid Organ or Hematopoietic Stem Cell Transplantation in a National Database Cohort.

Authors
  • Hahn, Seung Min1
  • Lee, Myeongjee2
  • Hyun, JongHoon3
  • Lim, Sungmin4
  • Kang, Ji-Man5, 6
  • Ahn, Jong Gyun5, 6
  • Joo, Dong Jin7
  • Jung, Inkyung8
  • Ihn, Kyong9
  • 1 Department of Pediatric Hematology-Oncology, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 2 Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 3 Division of Infectious Diseases, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea. , (North Korea)
  • 4 Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea. , (North Korea)
  • 5 Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 6 Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 7 Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 8 Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 9 Division of Pediatric Surgery, Severance Children's Hospital, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
Type
Published Article
Journal
Cancer research and treatment
Publication Date
Jan 01, 2024
Volume
56
Issue
1
Pages
305–313
Identifiers
DOI: 10.4143/crt.2023.647
PMID: 37475137
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Post-transplantation lymphoproliferative disorders (PTLDs) after hematopoietic stem transplantation (HCT) or solid organ transplantation (SOT) result in poorer outcomes, including death. There are limited large cohort data on the incidence and natural course of PTLD in Asians. We investigated PTLD using Korean national health insurance claims data of 47,518 patients who underwent HCT or SOT in 2008-2020. Patient demographics, time and type of PTLD diagnosis, type of PTLD treatment, and death data were collected. We used Fine and Gray subdistribution hazard models to calculate the cumulative incidence and risk factors for PTLD. During median follow-up of 5.32 years, PTLD occurred in 294 of 36,945 SOT patients (0.79%) and 235 of 10,573 HCT patients (2.22%). Cumulative incidence of PTLD were 0.49% at 1 year, 1.02% at 5 years, and 1.50% at 10 years post-transplantation. Age < 20 years (subdistribution hazard ratio [SHR] of 1.67 in age 10-19, SHR 1.51 in age 0-9), HCT (SHR 3.02), heart transplantation (SHR 2.27), and liver transplantation (SHR 1.47) were significant risk factors for PTLD. The presence of PTLD was associated with an increased risk of death (hazard ratio of 2.84). Overall, 5-year survival of PTLD patients was 68.9% (95% confidence interval, 64.9 to 73.2). We observed a steady increase in PTLD over 10 years after HCT or SOT in this large cohort study. Pediatric age group, HCT, liver transplantation, and heart transplantation were suggested to be risk factors for PTLD, and PTLD was associated with a higher risk of death.

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