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Contribution of solid organ transplant recipients to the pediatric non-Hodgkin lymphoma burden in the United States
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Jul 31 2017
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Source: Cancer. 123(23):4663-4671
Details:
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Alternative Title:Cancer
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Personal Author:
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Description:Background
Pediatric solid organ transplant recipients have 100–200 times higher risk of non-Hodgkin lymphoma (NHL) than the general pediatric population. Consequently, transplant-related NHLs may contribute considerably to the pediatric NHL burden in the US.
Methods
We conducted a cohort study using a linkage between the US transplant registry and 16 cancer registries. We calculated cancer incidence rates among people <20 years old in the transplant and general populations. Rates were applied to transplant registry and US census data to estimate pediatric NHL counts in transplant recipients and the general population.
Results
During 1990–2012, an estimated 22,270 NHLs were diagnosed in US children and adolescents, including 628 diagnoses in transplant recipients. Thus, 2.82% (95%CI=2.45–3.19%) of pediatric NHL diagnoses in the general population occurred in transplant recipients. Among transplant recipients, the most common subtypes were diffuse large B-cell lymphoma (DLBCL, 64.5% of cases) and Burkitt lymphoma (8.6%). For DLBCL and Burkitt lymphoma, transplant recipients contributed 7.62%, (95%CI=6.35–8.88%) and 0.87% (95%CI=0.51–1.23%) of diagnoses, respectively. The proportion of NHLs that occurred in transplant recipients was highest among children <5 years old (4.46%, 95%CI=3.24–5.69%) and in more recent calendar years (2010–2012: 3.73%, 95%CI=2.07–5.39%). DLBCL patterns were similar with transplant recipients contributing 19.78% of cases in children <5 years old (95%CI=12.89–26.66%) and 11.4% of cases in 2010–2012 (95%CI=5.54–17.28%).
Conclusions
Among children and adolescents, solid organ transplant recipients contribute a substantial fraction of NHL diagnoses, particularly for DLBCL. This fraction has increased over time. Prevention efforts targeted towards this group could reduce the overall pediatric NHL burden.
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Pubmed ID:28759103
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Pubmed Central ID:PMC5693631
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