신장 이식 후 림프증식질환의 임상양상 : 단일기관 25년간의 경험

Abstract

Background: Posttranplant lymphoproliferative disorder (PTLD) is a fatal complication of organ transplantation and standard treatment is either ineffective or too toxic to tolerate. This study aims to evaluate the characteristics of PTLD patients retrospectively.

Methods: We enrolled 2,630 kidney recipients who underwent transplantation from April 1979 to June 2007. And we retrospectively reviewed clinical manifestations of PTLD.

Results: Among one hundred ninety post-transplant malignancies from 2,630 renal recipients, 11 PTLD were diagnosed during 195.3±11.5 months (0∼388 months) of mean follow up duration. PTLD predominantly occurred in male (Male : Female=10 : 1) and mean age of PTLD patients at the time of PTLD diagnosis was 51±15 year (18∼71 year). Mean time interval to PTLD diagnosis were 126.6±74.8 months (6∼240 months). In aspect of WHO classification, there were no early lesion, 1 polymorphic PTLD (9.1%), 10 monomorphic PTLD (90.9%) and no other types. In aspect of involved organ, GI tract was involved in 1 case, lung in 2 cases, bone in 2 cases, spleen in 2 cases, neck node in 2 cases, liver in 1 case, and multiple organs in 1 case.

Conclusions: Our findings showed that the prevalence of PTLD was 0.46%, which was less than reports from Western countries. We also found that the late onset PTLD was more than early onset one, which was another difference from previous reports.