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post-transplantation lymphoproliferative disease
Saturday 5 September 2009
Posttransplantation lymphoproliferative disorders (PTLDs) are a spectrum of lymphoid proliferations, occurring in immunosuppressed organ transplant recipients. Most of them are associated with Epstein-Barr virus (EBV).
Types
early lesions polymorphic (P-PTLD) monomorphic (M-PTLD) Hodgkin/Hodgkin-like lymphoma PTLD (HL-PTLD)
Cytogenetics (16041261, 16283619)
Cytogenetic abnormalities were identified in 72% of monomorphic B-cell PTLDs and in all T-cell PTLDs, but in only 15% of polymorphic PTLDs and in no early lesions. (16283619)
Overall incidence of chromosomal imbalances at CGH: 51.5 %.
CGH gains : 8q24, 3q27, 2p24p25, 5p, 9q22q34, 11, 12q22q24, 14q32, 17q, 18q21.
CGH losses : 17p13; 1p36, 4q; 17q23q25, Xp.
Three high-level amplifications are detected: 4p16, 9p22p24, 18q21q23. In this latter imbalance, involvement of Bcl2 has been confirmed by FISH.
The nonrandom CGH imbalances occurring in M-PTLD are usually described in lymphomas of immunocompetent patients and contain genes known to be involved in lymphomagenesis, while genomic abnormalities detected in half cases of EBV positive P-PTLD are mostly unknown.
The most frequent clonal abnormalities in monomorphic PTLD were trisomies 9 and/or 11, followed by rearrangements of 8q24.1, 3q27, and 14q32.
MYC rearrangement (8q24.1) and T-cell-associated chromosomal abnormalities correlated with poor outcome and short survival.
PTLD with trisomy 9 and/or 11 developed early after transplant, presenting as Epstein-Barr virus-positive large B-cell lymphoma with prolonged survival.
References
Post-transplant lymphoproliferative disorder subtypes correlate with different recurring chromosomal abnormalities. Djokic M, Le Beau MM, Swinnen LJ, Smith SM, Rubin CM, Anastasi J, Carlson KM. Genes Chromosomes Cancer. 2006 Mar;45(3):313-8. PMID: 16283619
Characteristic pattern of chromosomal imbalances in posttransplantation lymphoproliferative disorders: correlation with histopathological subcategories and EBV status. Poirel HA, Bernheim A, Schneider A, Meddeb M, Choquet S, Leblond V, Charlotte F, Davi F, Canioni D, Macintyre E, Mamzer-Bruneel MF, Hirsch I, Hermine O, Martin A, Cornillet-Lefebvre P, Patey M, Toupance O, Kémény JL, Deteix P, Raphaël M. Transplantation. 2005 Jul 27;80(2):176-84. PMID: 16041261