B cell lymphoproliferative disorders following hematopoietic stem cell transplantation : risk factors, treatment and outcome

Twenty-six cases of B cell lymphoproliferative disorder (BLPD) were identified among 2395 patients following hematopoietic stem cell transplants (HSCT) for which an overall incidence of BLPD was 1.2%. The true incidence was probably higher, since 9/26 of the diagnoses were made at autopsy. No BLPD w...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Bone marrow transplantation (Basingstoke) 1999-02, Vol.23 (3), p.251-258
Hauptverfasser: GROSS, T. G, STEINBUCH, M, DEFOR, T, SHAPIRO, R. S, MCGLAVE, P, RAMSAY, N. K. C, WAGNER, J. E, FILIPOVICH, A. H
Format: Artikel
Sprache:eng
Schlagworte:
Age
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 258
container_issue 3
container_start_page 251
container_title Bone marrow transplantation (Basingstoke)
container_volume 23
creator GROSS, T. G
STEINBUCH, M
DEFOR, T
SHAPIRO, R. S
MCGLAVE, P
RAMSAY, N. K. C
WAGNER, J. E
FILIPOVICH, A. H
description Twenty-six cases of B cell lymphoproliferative disorder (BLPD) were identified among 2395 patients following hematopoietic stem cell transplants (HSCT) for which an overall incidence of BLPD was 1.2%. The true incidence was probably higher, since 9/26 of the diagnoses were made at autopsy. No BLPD was observed following autologous HSCT, so risk factor analyses were confined to the 1542 allogeneic HSCT. Factors assessed were HLA-mismatching (> or = 1 antigen), T cell depletion (TCD), presence of acute GvHD (grades II-IV), donor type (related vs unrelated), age of recipient and donor, and underlying disease. Factors found to be statistically significant included patients transplanted for immune deficiency and CML, donor age > or = 18 years, TCD, and HLA-mismatching, with recipients of combined TCD and HLA-mismatched grafts having the highest incidence. Factors found to be statistically significant in a multiple regression analysis were TCD, donor age and immune deficiency, although 7/8 of the patients with immunodeficiencies and BLPD received a TCD graft from a haploidentical parent. The overall mortality was 92% (24/26). One patient had a spontaneous remission, but subsequently died >1 year later of chronic GVHD. Thirteen patients received therapy for BLPD. Three patients received lymphocyte infusions without response. The only patients with responses and longterm survival received alpha interferon (alphaIFN). Of seven patients treated with alphaIFN there were four responses (one partial and three complete). These data demonstrate that alphaIFN can be an effective agent against BLPD following HSCT, if a timely diagnosis is made.
doi_str_mv 10.1038/sj.bmt.1701554
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7091602</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>69629107</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-3cca524124306c73c5541ee0787992071277aa0ff7c0363446ec1fdeb341a9dc3</originalsourceid><addsrcrecordid>eNqFkc2LFDEQxYMo7uzq1aMEFE_2mK9OJh4EXfyCBS96Dpl0ZSdjutMm6ZUF__jNMoOuXjzVoX7vUa8eQk8oWVPCN6_Kfr0d65oqQvte3EMrKpTsei77-2hFmNx0nEt9gk5L2RNChSD9Q3RCCdkI1ssV-vUOO4gRx-tx3qU5pxg8ZFvDFeAhlJQHyAX7FGP6GaZLvIPR1jSnADU4XCqMB33NdipztFNt2jTh1ziH8h1762rK5WXbg60jTBXbacBpqS6N8Ag98DYWeHycZ-jbh_dfzz91F18-fj5_e9E5oUTtuHO2Z4IywYl0iruWlAIQtVFaM6IoU8pa4r1yhEsuhARH_QBbLqjVg-Nn6M3Bd162IwyunZFtNHMOo83XJtlg_t5MYWcu05VRRFNJWDN4cTTI6ccCpZoxlNvcdoK0FCO1ZJoS9V-QKsa5VqKBz_4B92nJU_uCYVIwSpWSulHrA-VyKiWD_30zJea2f1P2pvVvjv03wdO7Se_gh8Ib8PwI2OJs9K02F8ofTrZv9ozfAJZtvCE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2642117769</pqid></control><display><type>article</type><title>B cell lymphoproliferative disorders following hematopoietic stem cell transplantation : risk factors, treatment and outcome</title><source>MEDLINE</source><source>Nature</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>GROSS, T. G ; STEINBUCH, M ; DEFOR, T ; SHAPIRO, R. S ; MCGLAVE, P ; RAMSAY, N. K. C ; WAGNER, J. E ; FILIPOVICH, A. H</creator><creatorcontrib>GROSS, T. G ; STEINBUCH, M ; DEFOR, T ; SHAPIRO, R. S ; MCGLAVE, P ; RAMSAY, N. K. C ; WAGNER, J. E ; FILIPOVICH, A. H</creatorcontrib><description>Twenty-six cases of B cell lymphoproliferative disorder (BLPD) were identified among 2395 patients following hematopoietic stem cell transplants (HSCT) for which an overall incidence of BLPD was 1.2%. The true incidence was probably higher, since 9/26 of the diagnoses were made at autopsy. No BLPD was observed following autologous HSCT, so risk factor analyses were confined to the 1542 allogeneic HSCT. Factors assessed were HLA-mismatching (&gt; or = 1 antigen), T cell depletion (TCD), presence of acute GvHD (grades II-IV), donor type (related vs unrelated), age of recipient and donor, and underlying disease. Factors found to be statistically significant included patients transplanted for immune deficiency and CML, donor age &gt; or = 18 years, TCD, and HLA-mismatching, with recipients of combined TCD and HLA-mismatched grafts having the highest incidence. Factors found to be statistically significant in a multiple regression analysis were TCD, donor age and immune deficiency, although 7/8 of the patients with immunodeficiencies and BLPD received a TCD graft from a haploidentical parent. The overall mortality was 92% (24/26). One patient had a spontaneous remission, but subsequently died &gt;1 year later of chronic GVHD. Thirteen patients received therapy for BLPD. Three patients received lymphocyte infusions without response. The only patients with responses and longterm survival received alpha interferon (alphaIFN). Of seven patients treated with alphaIFN there were four responses (one partial and three complete). These data demonstrate that alphaIFN can be an effective agent against BLPD following HSCT, if a timely diagnosis is made.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/sj.bmt.1701554</identifier><identifier>PMID: 10084256</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>Basingstoke: Nature Publishing Group</publisher><subject>Acyclovir - therapeutic use ; Adjuvants, Immunologic - therapeutic use ; Adolescent ; Adult ; Age ; AIDS/HIV ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Antigens ; Antiviral Agents - therapeutic use ; Autografts ; Autopsies ; Autopsy ; B-Lymphocytes - virology ; Biological and medical sciences ; Blood Donors ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Child ; Depletion ; Epstein-Barr Virus Infections - complications ; Epstein-Barr Virus Infections - drug therapy ; Epstein-Barr Virus Infections - epidemiology ; Epstein-Barr Virus Infections - transmission ; Female ; Genetic Diseases, Inborn - therapy ; Graft vs Host Disease - etiology ; Graft vs Host Disease - mortality ; Graft-versus-host reaction ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic stem cells ; Herpesvirus 4, Human - isolation &amp; purification ; Histocompatibility ; Histocompatibility antigen HLA ; Humans ; Immunocompromised Host ; Immunoglobulins, Intravenous - therapeutic use ; Immunophenotyping ; Immunoproliferative diseases ; Immunosuppression - adverse effects ; Incidence ; Infant ; Interferon ; Interferon-alpha - therapeutic use ; Leukemia - therapy ; Life Tables ; Lymphatic diseases ; Lymphocytes ; Lymphocytes T ; Lymphoproliferative Disorders - drug therapy ; Lymphoproliferative Disorders - epidemiology ; Lymphoproliferative Disorders - etiology ; Lymphoproliferative Disorders - immunology ; Lymphoproliferative Disorders - virology ; Male ; Medical sciences ; Middle Aged ; Multiple regression analysis ; Nuclear Family ; Parents ; Patients ; Remission ; Remission, Spontaneous ; Retrospective Studies ; Risk analysis ; Risk Factors ; Severe Combined Immunodeficiency - therapy ; Statistical analysis ; Stem cell transplantation ; Stem cells ; T-Lymphocytes, Cytotoxic - immunology ; T-Lymphocytes, Cytotoxic - pathology ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Transplantation, Homologous - adverse effects ; Transplants ; Transplants &amp; implants ; Treatment Outcome</subject><ispartof>Bone marrow transplantation (Basingstoke), 1999-02, Vol.23 (3), p.251-258</ispartof><rights>1999 INIST-CNRS</rights><rights>Macmillan Publishers Limited 1999.</rights><rights>Macmillan Publishers Limited 1999</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-3cca524124306c73c5541ee0787992071277aa0ff7c0363446ec1fdeb341a9dc3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=1671252$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10084256$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GROSS, T. G</creatorcontrib><creatorcontrib>STEINBUCH, M</creatorcontrib><creatorcontrib>DEFOR, T</creatorcontrib><creatorcontrib>SHAPIRO, R. S</creatorcontrib><creatorcontrib>MCGLAVE, P</creatorcontrib><creatorcontrib>RAMSAY, N. K. C</creatorcontrib><creatorcontrib>WAGNER, J. E</creatorcontrib><creatorcontrib>FILIPOVICH, A. H</creatorcontrib><title>B cell lymphoproliferative disorders following hematopoietic stem cell transplantation : risk factors, treatment and outcome</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><description>Twenty-six cases of B cell lymphoproliferative disorder (BLPD) were identified among 2395 patients following hematopoietic stem cell transplants (HSCT) for which an overall incidence of BLPD was 1.2%. The true incidence was probably higher, since 9/26 of the diagnoses were made at autopsy. No BLPD was observed following autologous HSCT, so risk factor analyses were confined to the 1542 allogeneic HSCT. Factors assessed were HLA-mismatching (&gt; or = 1 antigen), T cell depletion (TCD), presence of acute GvHD (grades II-IV), donor type (related vs unrelated), age of recipient and donor, and underlying disease. Factors found to be statistically significant included patients transplanted for immune deficiency and CML, donor age &gt; or = 18 years, TCD, and HLA-mismatching, with recipients of combined TCD and HLA-mismatched grafts having the highest incidence. Factors found to be statistically significant in a multiple regression analysis were TCD, donor age and immune deficiency, although 7/8 of the patients with immunodeficiencies and BLPD received a TCD graft from a haploidentical parent. The overall mortality was 92% (24/26). One patient had a spontaneous remission, but subsequently died &gt;1 year later of chronic GVHD. Thirteen patients received therapy for BLPD. Three patients received lymphocyte infusions without response. The only patients with responses and longterm survival received alpha interferon (alphaIFN). Of seven patients treated with alphaIFN there were four responses (one partial and three complete). These data demonstrate that alphaIFN can be an effective agent against BLPD following HSCT, if a timely diagnosis is made.</description><subject>Acyclovir - therapeutic use</subject><subject>Adjuvants, Immunologic - therapeutic use</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>AIDS/HIV</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Antigens</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Autografts</subject><subject>Autopsies</subject><subject>Autopsy</subject><subject>B-Lymphocytes - virology</subject><subject>Biological and medical sciences</subject><subject>Blood Donors</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Child</subject><subject>Depletion</subject><subject>Epstein-Barr Virus Infections - complications</subject><subject>Epstein-Barr Virus Infections - drug therapy</subject><subject>Epstein-Barr Virus Infections - epidemiology</subject><subject>Epstein-Barr Virus Infections - transmission</subject><subject>Female</subject><subject>Genetic Diseases, Inborn - therapy</subject><subject>Graft vs Host Disease - etiology</subject><subject>Graft vs Host Disease - mortality</subject><subject>Graft-versus-host reaction</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Hematopoietic stem cells</subject><subject>Herpesvirus 4, Human - isolation &amp; purification</subject><subject>Histocompatibility</subject><subject>Histocompatibility antigen HLA</subject><subject>Humans</subject><subject>Immunocompromised Host</subject><subject>Immunoglobulins, Intravenous - therapeutic use</subject><subject>Immunophenotyping</subject><subject>Immunoproliferative diseases</subject><subject>Immunosuppression - adverse effects</subject><subject>Incidence</subject><subject>Infant</subject><subject>Interferon</subject><subject>Interferon-alpha - therapeutic use</subject><subject>Leukemia - therapy</subject><subject>Life Tables</subject><subject>Lymphatic diseases</subject><subject>Lymphocytes</subject><subject>Lymphocytes T</subject><subject>Lymphoproliferative Disorders - drug therapy</subject><subject>Lymphoproliferative Disorders - epidemiology</subject><subject>Lymphoproliferative Disorders - etiology</subject><subject>Lymphoproliferative Disorders - immunology</subject><subject>Lymphoproliferative Disorders - virology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple regression analysis</subject><subject>Nuclear Family</subject><subject>Parents</subject><subject>Patients</subject><subject>Remission</subject><subject>Remission, Spontaneous</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Severe Combined Immunodeficiency - therapy</subject><subject>Statistical analysis</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>T-Lymphocytes, Cytotoxic - immunology</subject><subject>T-Lymphocytes, Cytotoxic - pathology</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><subject>Transplantation</subject><subject>Transplantation, Homologous - adverse effects</subject><subject>Transplants</subject><subject>Transplants &amp; implants</subject><subject>Treatment Outcome</subject><issn>0268-3369</issn><issn>1476-5365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc2LFDEQxYMo7uzq1aMEFE_2mK9OJh4EXfyCBS96Dpl0ZSdjutMm6ZUF__jNMoOuXjzVoX7vUa8eQk8oWVPCN6_Kfr0d65oqQvte3EMrKpTsei77-2hFmNx0nEt9gk5L2RNChSD9Q3RCCdkI1ssV-vUOO4gRx-tx3qU5pxg8ZFvDFeAhlJQHyAX7FGP6GaZLvIPR1jSnADU4XCqMB33NdipztFNt2jTh1ziH8h1762rK5WXbg60jTBXbacBpqS6N8Ag98DYWeHycZ-jbh_dfzz91F18-fj5_e9E5oUTtuHO2Z4IywYl0iruWlAIQtVFaM6IoU8pa4r1yhEsuhARH_QBbLqjVg-Nn6M3Bd162IwyunZFtNHMOo83XJtlg_t5MYWcu05VRRFNJWDN4cTTI6ccCpZoxlNvcdoK0FCO1ZJoS9V-QKsa5VqKBz_4B92nJU_uCYVIwSpWSulHrA-VyKiWD_30zJea2f1P2pvVvjv03wdO7Se_gh8Ib8PwI2OJs9K02F8ofTrZv9ozfAJZtvCE</recordid><startdate>19990201</startdate><enddate>19990201</enddate><creator>GROSS, T. G</creator><creator>STEINBUCH, M</creator><creator>DEFOR, T</creator><creator>SHAPIRO, R. S</creator><creator>MCGLAVE, P</creator><creator>RAMSAY, N. K. C</creator><creator>WAGNER, J. E</creator><creator>FILIPOVICH, A. H</creator><general>Nature Publishing Group</general><general>Nature Publishing Group UK</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19990201</creationdate><title>B cell lymphoproliferative disorders following hematopoietic stem cell transplantation : risk factors, treatment and outcome</title><author>GROSS, T. G ; STEINBUCH, M ; DEFOR, T ; SHAPIRO, R. S ; MCGLAVE, P ; RAMSAY, N. K. C ; WAGNER, J. E ; FILIPOVICH, A. H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-3cca524124306c73c5541ee0787992071277aa0ff7c0363446ec1fdeb341a9dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Acyclovir - therapeutic use</topic><topic>Adjuvants, Immunologic - therapeutic use</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>AIDS/HIV</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Antigens</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Autografts</topic><topic>Autopsies</topic><topic>Autopsy</topic><topic>B-Lymphocytes - virology</topic><topic>Biological and medical sciences</topic><topic>Blood Donors</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>Child</topic><topic>Depletion</topic><topic>Epstein-Barr Virus Infections - complications</topic><topic>Epstein-Barr Virus Infections - drug therapy</topic><topic>Epstein-Barr Virus Infections - epidemiology</topic><topic>Epstein-Barr Virus Infections - transmission</topic><topic>Female</topic><topic>Genetic Diseases, Inborn - therapy</topic><topic>Graft vs Host Disease - etiology</topic><topic>Graft vs Host Disease - mortality</topic><topic>Graft-versus-host reaction</topic><topic>Hematopoietic Stem Cell Transplantation - adverse effects</topic><topic>Hematopoietic stem cells</topic><topic>Herpesvirus 4, Human - isolation &amp; purification</topic><topic>Histocompatibility</topic><topic>Histocompatibility antigen HLA</topic><topic>Humans</topic><topic>Immunocompromised Host</topic><topic>Immunoglobulins, Intravenous - therapeutic use</topic><topic>Immunophenotyping</topic><topic>Immunoproliferative diseases</topic><topic>Immunosuppression - adverse effects</topic><topic>Incidence</topic><topic>Infant</topic><topic>Interferon</topic><topic>Interferon-alpha - therapeutic use</topic><topic>Leukemia - therapy</topic><topic>Life Tables</topic><topic>Lymphatic diseases</topic><topic>Lymphocytes</topic><topic>Lymphocytes T</topic><topic>Lymphoproliferative Disorders - drug therapy</topic><topic>Lymphoproliferative Disorders - epidemiology</topic><topic>Lymphoproliferative Disorders - etiology</topic><topic>Lymphoproliferative Disorders - immunology</topic><topic>Lymphoproliferative Disorders - virology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple regression analysis</topic><topic>Nuclear Family</topic><topic>Parents</topic><topic>Patients</topic><topic>Remission</topic><topic>Remission, Spontaneous</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Severe Combined Immunodeficiency - therapy</topic><topic>Statistical analysis</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>T-Lymphocytes, Cytotoxic - immunology</topic><topic>T-Lymphocytes, Cytotoxic - pathology</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Transplantation</topic><topic>Transplantation, Homologous - adverse effects</topic><topic>Transplants</topic><topic>Transplants &amp; implants</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GROSS, T. G</creatorcontrib><creatorcontrib>STEINBUCH, M</creatorcontrib><creatorcontrib>DEFOR, T</creatorcontrib><creatorcontrib>SHAPIRO, R. S</creatorcontrib><creatorcontrib>MCGLAVE, P</creatorcontrib><creatorcontrib>RAMSAY, N. K. C</creatorcontrib><creatorcontrib>WAGNER, J. E</creatorcontrib><creatorcontrib>FILIPOVICH, A. H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Bone marrow transplantation (Basingstoke)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GROSS, T. G</au><au>STEINBUCH, M</au><au>DEFOR, T</au><au>SHAPIRO, R. S</au><au>MCGLAVE, P</au><au>RAMSAY, N. K. C</au><au>WAGNER, J. E</au><au>FILIPOVICH, A. H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>B cell lymphoproliferative disorders following hematopoietic stem cell transplantation : risk factors, treatment and outcome</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><addtitle>Bone Marrow Transplant</addtitle><date>1999-02-01</date><risdate>1999</risdate><volume>23</volume><issue>3</issue><spage>251</spage><epage>258</epage><pages>251-258</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><coden>BMTRE9</coden><abstract>Twenty-six cases of B cell lymphoproliferative disorder (BLPD) were identified among 2395 patients following hematopoietic stem cell transplants (HSCT) for which an overall incidence of BLPD was 1.2%. The true incidence was probably higher, since 9/26 of the diagnoses were made at autopsy. No BLPD was observed following autologous HSCT, so risk factor analyses were confined to the 1542 allogeneic HSCT. Factors assessed were HLA-mismatching (&gt; or = 1 antigen), T cell depletion (TCD), presence of acute GvHD (grades II-IV), donor type (related vs unrelated), age of recipient and donor, and underlying disease. Factors found to be statistically significant included patients transplanted for immune deficiency and CML, donor age &gt; or = 18 years, TCD, and HLA-mismatching, with recipients of combined TCD and HLA-mismatched grafts having the highest incidence. Factors found to be statistically significant in a multiple regression analysis were TCD, donor age and immune deficiency, although 7/8 of the patients with immunodeficiencies and BLPD received a TCD graft from a haploidentical parent. The overall mortality was 92% (24/26). One patient had a spontaneous remission, but subsequently died &gt;1 year later of chronic GVHD. Thirteen patients received therapy for BLPD. Three patients received lymphocyte infusions without response. The only patients with responses and longterm survival received alpha interferon (alphaIFN). Of seven patients treated with alphaIFN there were four responses (one partial and three complete). These data demonstrate that alphaIFN can be an effective agent against BLPD following HSCT, if a timely diagnosis is made.</abstract><cop>Basingstoke</cop><pub>Nature Publishing Group</pub><pmid>10084256</pmid><doi>10.1038/sj.bmt.1701554</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0268-3369
ispartof Bone marrow transplantation (Basingstoke), 1999-02, Vol.23 (3), p.251-258
issn 0268-3369
1476-5365
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7091602
source MEDLINE; Nature; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Acyclovir - therapeutic use
Adjuvants, Immunologic - therapeutic use
Adolescent
Adult
Age
AIDS/HIV
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Antigens
Antiviral Agents - therapeutic use
Autografts
Autopsies
Autopsy
B-Lymphocytes - virology
Biological and medical sciences
Blood Donors
Bone marrow, stem cells transplantation. Graft versus host reaction
Child
Depletion
Epstein-Barr Virus Infections - complications
Epstein-Barr Virus Infections - drug therapy
Epstein-Barr Virus Infections - epidemiology
Epstein-Barr Virus Infections - transmission
Female
Genetic Diseases, Inborn - therapy
Graft vs Host Disease - etiology
Graft vs Host Disease - mortality
Graft-versus-host reaction
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic stem cells
Herpesvirus 4, Human - isolation & purification
Histocompatibility
Histocompatibility antigen HLA
Humans
Immunocompromised Host
Immunoglobulins, Intravenous - therapeutic use
Immunophenotyping
Immunoproliferative diseases
Immunosuppression - adverse effects
Incidence
Infant
Interferon
Interferon-alpha - therapeutic use
Leukemia - therapy
Life Tables
Lymphatic diseases
Lymphocytes
Lymphocytes T
Lymphoproliferative Disorders - drug therapy
Lymphoproliferative Disorders - epidemiology
Lymphoproliferative Disorders - etiology
Lymphoproliferative Disorders - immunology
Lymphoproliferative Disorders - virology
Male
Medical sciences
Middle Aged
Multiple regression analysis
Nuclear Family
Parents
Patients
Remission
Remission, Spontaneous
Retrospective Studies
Risk analysis
Risk Factors
Severe Combined Immunodeficiency - therapy
Statistical analysis
Stem cell transplantation
Stem cells
T-Lymphocytes, Cytotoxic - immunology
T-Lymphocytes, Cytotoxic - pathology
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Transplantation
Transplantation, Homologous - adverse effects
Transplants
Transplants & implants
Treatment Outcome
title B cell lymphoproliferative disorders following hematopoietic stem cell transplantation : risk factors, treatment and outcome
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T06%3A09%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=B%20cell%20lymphoproliferative%20disorders%20following%20hematopoietic%20stem%20cell%20transplantation%20:%20risk%20factors,%20treatment%20and%20outcome&rft.jtitle=Bone%20marrow%20transplantation%20(Basingstoke)&rft.au=GROSS,%20T.%20G&rft.date=1999-02-01&rft.volume=23&rft.issue=3&rft.spage=251&rft.epage=258&rft.pages=251-258&rft.issn=0268-3369&rft.eissn=1476-5365&rft.coden=BMTRE9&rft_id=info:doi/10.1038/sj.bmt.1701554&rft_dat=%3Cproquest_pubme%3E69629107%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2642117769&rft_id=info:pmid/10084256&rfr_iscdi=true