Burkitt lymphoma risk in U.S. solid organ transplant recipients

Details

• Alternative Title:
  Am J Hematol
• Personal Author:
  Mbulaiteye, Sam M. ; Clarke, Christina A. ; Morton, Lindsay M. ; Gibson, Todd M. ; Pawlish, Karen ; Weisenburger, Dennis D. ; Lynch, Charles F. ; Goodman, Marc T. ; Engels, Eric A.
• Description:
  Case reports of Burkitt lymphoma (BL) in transplant recipients suggest that the risk is markedly elevated. Therefore, we investigated the incidence of BL in 203,557 solid organ recipients in the U.S. Transplant Cancer Match Study (1987-2009) and compared it with the general population using standardized incidence ratios. We also assessed associations with demographic and clinical characteristics, and treatments used to induce therapeutic immunosuppression. BL incidence was 10.8 per 100,000 person-years, representing 23-fold (95% confidence interval (CI) 19-28) greater risk than in the general population, and it peaked 3-8 years after the time of transplantation. In adjusted analyses, BL incidence was higher in recipients transplanted when <18 vs. ≥35 years (incidence rate ratio [IRR] 3.49, 95% CI 2.08-5.68) and in those transplanted with a liver (IRR 2.91, 95% CI 1.68-5.09) or heart (IRR 2.39, 95% CI 1.30-4.31) compared with kidney. BL incidence was lower in females than males (IRR 0.45, 95% CI 0.28-0.71), in blacks than whites (IRR 0.33, 95% CI 0.12-0.74), in those with a baseline Epstein-Barr virus (EBV)-seropositive versus EBV-seronegative status (IRR 0.34, 95% CI 0.13-0.93), and in those treated with azathioprine (IRR 0.56, 95% CI 0.34-0.89) or corticosteroids (IRR 0.48, 95% CI 0.29-0.82). Tumors were EBV-positive in 69% of 32 cases with results. EBV positivity was 90% in those aged <18 years and 59% in those aged 18+ years. In conclusion, BL risk is markedly elevated in transplant recipients, and it is associated with certain demographic and clinical features. EBV was positive in most but not all BL cases with results.
• Subjects:
  Adolescent Adult Aged Age Factors Black Or African American Burkitt Lymphoma Child Child, Preschool Female Heart Transplantation Herpesvirus 4, Human Humans Immunosuppression Incidence Infant Infant, Newborn Kidney Transplantation Liver Transplantation Middle Aged Registries Risk Sex Factors White People

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• Source:
  Am J Hematol. 88(4):245-250.
• Pubmed ID:
  23386365
• Pubmed Central ID:
  PMC3608801
• Document Type:
  Journal Article
• Funding:
  HHSN261201000037C/CA/NCI NIH HHS/United States ; N01PC35143/CA/NCI NIH HHS/United States ; U58 DP000805/DP/NCCDPHP CDC HHS/United States ; U58 DP000817/DP/NCCDPHP CDC HHS/United States ; HHSN261201000035C/CA/NCI NIH HHS/United States ; HHSN261201000036C/CA/NCI NIH HHS/United States ; N01PC35137/CA/NCI NIH HHS/United States ; U58 DP000807/DP/NCCDPHP CDC HHS/United States ; U58 DP000808/DP/NCCDPHP CDC HHS/United States ; T32 CA126607/CA/NCI NIH HHS/United States ; N01PC35142/CA/NCI NIH HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; U58 DP000848/DP/NCCDPHP CDC HHS/United States ; U58 DP000812/DP/NCCDPHP CDC HHS/United States ; HHSN261201000024C/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; N01PC54405/CA/NCI NIH HHS/United States ; ZIA CP010176-11/Intramural NIH HHS/United States ; U58 DP000832/DP/NCCDPHP CDC HHS/United States ; N01PC35139/CA/NCI NIH HHS/United States ; HHSN261201000026C/CA/NCI NIH HHS/United States ; U58 DP000824/DP/NCCDPHP CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  88
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:41b949be9d1f8c2a6ecee04c05fe0b423be90c3999475c8bd74d6467073c3d54
• Download URL:
  https://stacks.cdc.gov/view/cdc/41881/cdc_41881_DS1.pdf
• File Type:
  [PDF - 178.82 KB ]