Plasmacytic post-transplant lymphoproliferative disorder: a case series of nine patients. Transpl Int 2013 Jun;26(6):616-22
Date
04/05/2013Pubmed ID
23551167DOI
10.1111/tri.12091Scopus ID
2-s2.0-84878012301 (requires institutional sign-in at Scopus site) 33 CitationsAbstract
Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of organ transplantation. Although PTLD typically has a B-cell histology, an uncommon variant, plasmacytic PTLD can present as a monoclonal plasma cell proliferation similar to plasmacytomas seen in multiple myeloma. A retrospective analysis was performed on nine patients at our center with plasmacytic PTLD as characterized by plasmacytic histology with the presence of CD138 and lack of CD20. Of the 210 adult solid organ transplant PTLD patients diagnosed between 1988 and 2012, 9 (4%) had a histological appearance consistent with plasmacytic PTLD. The median time from transplant to diagnosis was 3.7 years (range 8 months-24 years). All patients presented with extranodal and often subcutaneous solid tumors. Laboratory features included elevated LDH and beta-2 microglobulin levels, monoclonal gammopathy, and EBV positivity of the tumor. Unlike conventional multiple myeloma, patients had normal calcium levels and only mild anemia. Six patients who have completed treatment achieved complete responses with radiation therapy and/or reduction in immunosuppression with two patients now greater than 5 years in continuous complete response. Plasmacytic PTLD, despite its plasmacytic histology, is responsive to conventional therapies used for B-cell PTLD including reduction in immunosuppression and radiation therapy.
Author List
Karuturi M, Shah N, Frank D, Fasan O, Reshef R, Ahya VN, Bromberg M, Faust T, Goral S, Schuster SJ, Stadtmauer EA, Tsai DEAuthor
Nirav N. Shah MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedEpstein-Barr Virus Infections
Female
Humans
Lymphoma
Lymphoproliferative Disorders
Male
Middle Aged
Organ Transplantation
Plasma Cells
Plasmacytoma
Retrospective Studies
