Incidence and outcomes of primary central nervous system lymphoma in solid organ transplant recipients

Details

• Alternative Title:
  Am J Transplant
• Personal Author:
  Mahale, Parag ; Shiels, Meredith S. ; Lynch, Charles F. ; Engels, Eric A.
• Description:
  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.
• Subjects:
  Article
• Source:
  Am J Transplant. 18(2):453-461
• Pubmed ID:
  28805292
• Pubmed Central ID:
  PMC5790603
• Document Type:
  Journal Article
• Funding:
  U58 DP003931/DP/NCCDPHP CDC HHS/United States ; HHSN261201000037C/CA/NCI NIH HHS/United States ; N01PC35143/CA/NCI NIH HHS/United States ; HHSN261201300019C/CA/NCI NIH HHS/United States ; U58 DP003883/DP/NCCDPHP CDC HHS/United States ; Z99 CA999999/NULL/International ; HHSN261201000035C/CA/NCI NIH HHS/United States ; U58 DP003875/DP/NCCDPHP CDC HHS/United States ; P30 CA086862/CA/NCI NIH HHS/United States ; HHSN261201000036C/CA/NCI NIH HHS/United States ; U58 DP003879/DP/NCCDPHP CDC HHS/United States ; N01PC35137/CA/NCI NIH HHS/United States ; HHSN261201300071C/CA/NCI NIH HHS/United States ; U58 DP003920/DP/NCCDPHP CDC HHS/United States ; HHSN261201300011C/RC/CCR NIH HHS/United States ; U58 DP000807/DP/NCCDPHP CDC HHS/United States ; N01PC35142/CA/NCI NIH HHS/United States ; HHSN261201300021C/CA/NCI NIH HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; U58 DP000848/DP/NCCDPHP CDC HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; U58 DP003921/DP/NCCDPHP CDC HHS/United States ; HHSN261201300011I/CA/NCI NIH HHS/United States ; U58 DP000832/DP/NCCDPHP CDC HHS/United States ; N01PC35139/CA/NCI NIH HHS/United States ; U58 DP000824/DP/NCCDPHP CDC HHS/United States
• Volume:
  18
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c36893d8bbbdc883601743de2becc05a6c8861f42d70a1b2161a407989151a20
• Download URL:
  https://stacks.cdc.gov/view/cdc/51291/cdc_51291_DS1.pdf
• File Type:
  [PDF - 464.57 KB ]