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Primary cutaneous posttransplant lymphoproliferative disorders in solid organ transplant recipients: A multicenter European case series

par Seckin, Deniz;Barete, Stéphane;Euvrard, Sylvie;Francès, Camille;Kanitakis, Jean;Geusau, Alexandra;Del Marmol, Véronique ;Harwood, Catherine Anne;Proby, Charlotte;Ali, Iaisha;Güleç, Ayşe Tülin;Durukan, Elif;Lebbe, Céleste;Alaibac, Mauro;Laffitte, Emmanuel;Cooper, S.;Bouwes Bavinck, Jan Nico;Murphy, Gi;Ferrandiz, Carlos Ferrándiz;Mørk, Cato;Cetkovská, Petra;Kempf, Werner;Hofbauer, Günther Franz
Référence American Journal of Transplantation, 13, 8, page (2146-2153)
Publication Publié, 2013-08

Article révisé par les pairs

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Résumé :

Primary cutaneous posttransplant lymphoproliferative disorders (PTLD) are rare. This retrospective, multicenter study of 35 cases aimed to better describe this entity. Cases were (re)-classified according to the WHO-EORTC or the WHO 2008 classifications of lymphomas. Median interval between first transplantation and diagnosis was 85 months. Fifty-seven percent of patients had a kidney transplant. Twenty-four cases (68.6%) were classified as primary cutaneous T cell lymphoma (CTCL) and 11 (31.4%) as primary cutaneous B cell PTLD. Mycosis fungoides (MF) was the most common (50%) CTCL subtype. Ten (90.9%) cutaneous B cell PTLD cases were classified as EBV-associated B cell lymphoproliferations (including one plasmablastic lymphoma and one lymphomatoid granulomatosis) and one as diffuse large B cell lymphoma, other, that was EBV-negative. Sixteen (45.7%) patients died after a median follow-up of 19.5 months (11 [68.8%] with CTCL [6 of whom had CD30+ lymphoproliferative disorders (LPD)] and 5 [31.2%] with cutaneous B cell PTLD. Median survival times for all patients, CTCL and cutaneous B cell PTLD subgroups were 93, 93, and 112 months, respectively. Survival rates for MF were higher than those for CD30+ LPD. The spectrum of primary CTCL in organ transplant recipients (OTR) is similar to that in the general population. The prognosis of posttransplant primary cutaneous CD30+ LPD is worse than posttransplant MF and than its counterpart in the immunocompetent population. EBV-associated cutaneous B cell LPD predominates in OTR. This case series suggests that primary cutaneous posttransplant lymphoproliferative disorders of T cell origin are more common than those of B cell origin, the spectrum of primary cutaneous T cell lymphoma in organ transplant recipients is similar to that in the general population, the prognosis of posttransplant primary cutaneous CD30+ lymphoproliferative disorders is worse than its counterpart in the immunocompetent population, and EBV-associated cutaneous B cell lymphoproliferative disorders predominate in organ transplant recipients. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.