Primary central nervous system posttransplantation lymphoproliferative disorder after heart and lung transplantation

G Gifford; K Fay; A Jabbour; D D Ma

doi:10.1111/imj.12735

Primary central nervous system posttransplantation lymphoproliferative disorder after heart and lung transplantation

Intern Med J. 2015 May;45(5):583-6. doi: 10.1111/imj.12735.

Authors

G Gifford¹, K Fay^{1

2}, A Jabbour^{3

4

5}, D D Ma^{1

4

6}

Affiliations

¹ Haematology Department, St Vincent's Hospital, Sydney, New South Wales, Australia.
² Cardiology Department, St Vincent's Hospital, Sydney, New South Wales, Australia.
³ Haematology Department, Royal North Shore Hospital, Sydney, New South Wales, Australia.
⁴ Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
⁵ Clinical Faculty, Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia.
⁶ St Vincent's Centre for Applied Medical Research, Sydney, New South Wales, Australia.

PMID: 25955465
DOI: 10.1111/imj.12735

Abstract

Primary central nervous system posttransplantation lymphoproliferative disorder (PCNS-PTLD) is uncommon, especially after heart or lung transplantation. Database analysis from a single heart and lung transplantation centre and a literature review pertaining to PCNS-PTLD was performed. In this study, the prevalence of PCNS-PTLD was 0.18% after heart and/or lung transplants. Of 1674 transplants, three cases of PCNS-PTLD developed 14 months, 9 years and 17 years posttransplant, and all were Epstein-Barr virus driven malignancies. Literature review of the topic revealed predominantly retrospective studies, with most reported cases after renal transplantation. The overall survival is poor, and it may be improved by early diagnosis and treatment. There are no published guidelines on the management of PCNS-PTLD; immune-chemotherapy in conjunction with reduction of immune suppression is preferred based on available evidence.

Keywords: central nervous system; heart; lung; lymphoma; posttransplant lymhpoproliferative disorder; transplantation.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Aged
Central Nervous System Diseases / diagnosis*
Central Nervous System Diseases / etiology
Central Nervous System Diseases / immunology
Cytomegalovirus Infections / complications
Cytomegalovirus Infections / immunology
Cytomegalovirus Infections / prevention & control*
Epstein-Barr Virus Infections / complications
Epstein-Barr Virus Infections / immunology
Epstein-Barr Virus Infections / prevention & control*
Heart Transplantation*
Humans
Immunocompromised Host / immunology*
Immunosuppressive Agents / administration & dosage*
Incidence
Lung Transplantation*
Lymphoproliferative Disorders / diagnosis*
Lymphoproliferative Disorders / etiology
Lymphoproliferative Disorders / immunology
Male
Middle Aged
Postoperative Complications / diagnosis*
Postoperative Complications / immunology
Prognosis
Retrospective Studies
Transplant Recipients
Treatment Outcome

Substances

Immunosuppressive Agents