Journal article
Incidence and outcomes of primary central nervous system lymphoma in solid organ transplant recipients
American journal of transplantation, Vol.18(2), pp.453-461
02/2018
DOI: 10.1111/ajt.14465
PMCID: PMC5790603
PMID: 28805292
Abstract
Primary central nervous system lymphoma (PCNSL) risk is greatly increased in immunosuppressed human immunodeficiency virus-infected people. Using data from the US transplant registry linked with 17 cancer registries (1987-2014), we studied PCNSL and systemic non-Hodgkin lymphoma (NHL) in 288 029 solid organ transplant recipients. Transplant recipients had elevated incidence for PCNSL compared with the general population (standardized incidence ratio = 65.1; N = 168), and this elevation was stronger than for systemic NHL (standardized incidence ratio=11.5; N = 2043). Compared to kidney recipients, PCNSL incidence was lower in liver recipients (adjusted incidence rate ratio [aIRR] = 0.52), similar in heart and/or lung recipients, and higher in other/multiple organ recipients (aIRR = 2.45). PCNSL incidence was higher in Asians/Pacific Islanders than non-Hispanic whites (aIRR = 2.09); after induction immunosuppression with alemtuzumab (aIRR = 3.12), monoclonal antibodies (aIRR = 1.83), or polyclonal antibodies (aIRR = 2.03); in recipients who were Epstein-Barr virus-seronegative at the time of transplant and at risk of primary infection (aIRR = 1.95); and within the first 1.5 years after transplant. Compared to other recipients, those with PCNSL had increased risk of death (adjusted hazard ratio [aHR] = 11.79) or graft failure/retransplantation (aHR = 3.24). Recipients with PCNSL also had higher mortality than those with systemic NHL (aHR = 1.48). In conclusion, PCNSL risk is highly elevated among transplant recipients, and it carries a poor prognosis.
Details
- Title: Subtitle
- Incidence and outcomes of primary central nervous system lymphoma in solid organ transplant recipients
- Creators
- Parag Mahale - Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USAMeredith S Shiels - Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USACharles F Lynch - Department of Epidemiology, The University of Iowa College of Public Health, Iowa City, IA, USAEric A Engels - Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.18(2), pp.453-461
- Publisher
- United States
- DOI
- 10.1111/ajt.14465
- PMID
- 28805292
- PMCID
- PMC5790603
- ISSN
- 1600-6143
- eISSN
- 1600-6143
- Grant note
- N01PC35142 / NCI NIH HHS U58 DP000807 / NCCDPHP CDC HHS U58 DP000824 / NCCDPHP CDC HHS HHSN261201000036C / NCI NIH HHS U58 DP003875 / NCCDPHP CDC HHS U58 DP003931 / NCCDPHP CDC HHS N01PC35137 / NCI NIH HHS U58 DP003921 / NCCDPHP CDC HHS U58 DP000832 / NCCDPHP CDC HHS HHSN261201000035C / NCI NIH HHS U58 DP003879 / NCCDPHP CDC HHS HHSN261201300011C / CCR NIH HHS HHSN261201300071C / NCI NIH HHS U58 DP003920 / NCCDPHP CDC HHS U58 DP000848 / NCCDPHP CDC HHS HHSN261201000034C / NCI NIH HHS N01PC35139 / NCI NIH HHS P30 CA086862 / NCI NIH HHS HHSN261201300021C / NCI NIH HHS HHSN261201300011I / NCI NIH HHS HHSN261201000037C / NCI NIH HHS N01PC35143 / NCI NIH HHS Z99 CA999999 / Intramural NIH HHS HHSN261201300019C / NCI NIH HHS U58 DP003883 / NCCDPHP CDC HHS HHSN261201000035I / NCI NIH HHS
- Language
- English
- Date published
- 02/2018
- Academic Unit
- Epidemiology
- Record Identifier
- 9983995123702771
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