PTLD: Clinical Characteristics and Outcomes in Argentina

FERNANDO WARLEY; FEDERICO JAUK; VICTORIA OTERO; MARIA FLORENCIA TISI BAÑA; BONANNO, MARINA; DANA KOHAN; GARCÍA RIVELLO, HERNÁN

Houston

Encuentro; The fifth annual meeting of the Society of Hematologic Oncology; 2017

Society of Hematologic Oncology

Context: Post-transplant lymphoproliferative disorders (PTLD) are an heterogeneous group of lymphoid proliferations occurring after solid organ or allogeneic HSCT. Diagnosis is challenging, requires expert pathologist and high clinical suspicion. Data from Latin America is lacking. Objective: Describe clinical and anatomopathological characteristics of PTLD in Argentina. Evaluate overall survival in our population. Design: Retrospective cohort study, January 2001-April 2017. All patients followed from diagnosis until death or lost to follow up. Setting: Study was conducted at Hospital Italiano de Buenos Aires, an integrated health care system accounting 2 university hospitals, 23 outpatient centers and a Basic Science Institute. Patients or Other Participants: Consecutive patients with PTLD confirmed diagnosis by WHO 2016 criteria and available data were included. Patients with more than one PTLD were analyzed once for clinical variables. Main Outcomes Measures: Descriptive statistics for clinical and anatomopathological characteristics. Quantitative variables are expressed as median and range; qualitative variables as total number and percentage. Overall survival measured in months from diagnosis till death or last visit. Results: Forty-one patients with PTLD were included. Baseline characteristics are shown in Table 1. Five patients had more than one PTLD. Median time from transplant to PTLD was 45 months (IQR 13-116) for entire cohort (83.5 for renal and 40 for hepatic transplantation); 91.5 for adults and 33 for pediatrics). Thirty patients had extranodal involvement. Forty patients were treated (Table 2). Treatment was frequently concomitant. No EBV mismatch was reported. EBV EBER was negative in 11 (26.8%) patients. Ten patients die; only one with disease progression. Overall survival at 5 years is 0.77 (CI 95% 0.60-0.88). Conclusions: This is the first large series of patients from Argentina. Characteristics and management differ between pediatrics and adults, because of distinct type of PTLD. Most patients die without active lymphoma. Additional immunohistochemistry, clonality and NGS is being performed. Larger collaborative studies are needed.