Risk of lymphoma subtypes after solid organ transplantation in the United States
Published Date:Jun 11 2013
Source:Br J Cancer. 2013; 109(1):280-288.
Aged, 80 And Over
Pubmed Central ID:PMC3708563
Funding:1U58 DP000807-01/DP/NCCDPHP CDC HHS/United States
5658DP000805-04/DP/NCCDPHP CDC HHS/United States
5U58/DP000808-05/DP/NCCDPHP CDC HHS/United States
5U58DP000812-03/DP/NCCDPHP CDC HHS/United States
5U58DP000817-05/DP/NCCDPHP CDC HHS/United States
5U58DP000824-04/DP/NCCDPHP CDC HHS/United States
HHSH234200537009C/PHS HHS/United States
HHSH250201000018C/PHS HHS/United States
HHSN261201000024C/PHS HHS/United States
HHSN261201000026C/PHS HHS/United States
HHSN261201000027C/PHS HHS/United States
HHSN261201000032C/PHS HHS/United States
HHSN261201000034C/PHS HHS/United States
HHSN261201000035C/PHS HHS/United States
HHSN261201000037C/PHS HHS/United States
HHSN261201000040C/PHS HHS/United States
K07 CA140360/CA/NCI NIH HHS/United States
N01-PC-35137/PC/NCI NIH HHS/United States
N01-PC-35139/PC/NCI NIH HHS/United States
N01-PC-35142/PC/NCI NIH HHS/United States
N01-PC-35143/PC/NCI NIH HHS/United States
N01-PC-54405/PC/NCI NIH HHS/United States
U58DP000832/DP/NCCDPHP CDC HHS/United States
U58DP000848-04/DP/NCCDPHP CDC HHS/United States
Solid organ transplant recipients have high risk of lymphomas, including non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). A gap in our understanding of post-transplant lymphomas involves the spectrum and associated risks of their many histologic subtypes.
We linked nationwide data on solid organ transplants from the US Scientific Registry of Transplant Recipients (1987–2008) to 14 state and regional cancer registries, yielding 791 281 person-years of follow-up for 19 distinct NHL subtypes and HL. We calculated standardised incidence ratios (SIRs) and used Poisson regression to compare SIRs by recipient age, transplanted organ, and time since transplantation.
The risk varied widely across subtypes, with strong elevations (SIRs 10–100) for hepatosplenic T-cell lymphoma, Burkitt's lymphoma, NK/T-cell lymphoma, diffuse large B-cell lymphoma, and anaplastic large-cell lymphoma (both systemic and primary cutaneous forms). Moderate elevations (SIRs 2–4) were observed for HL and lymphoplasmacytic, peripheral T-cell, and marginal zone lymphomas, but SIRs for indolent lymphoma subtypes were not elevated. Generally, SIRs were highest for younger recipients (<20 years) and those receiving organs other than kidneys.
Transplant recipients experience markedly elevated risk of a distinct spectrum of lymphoma subtypes. These findings support the aetiologic relevance of immunosuppression for certain subtypes and underscore the importance of detailed haematopathologic workup for transplant recipients with suspected lymphoma.
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