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Afify Z, Orjuela-G rimm M, Smith CM, Dalal M, Ford JB, Pillai P, Robles JM, Reddy S, McCormack S, Ehrhardt MJ, Ureda T, Alperstein W, Edington H, Miller TP, Rubinstein JD, Kavanaugh M, Bukowinski AJ, Friehling E, Rivers JM, Chisholm KM, Marks LJ, Mason CC. Burkitt lymphoma after solid-organ transplant: Treatment and outcomes in the paediatric PTLD collaborative. Br J Haematol 2023; 200:297-305. [PMID: 36454546 PMCID: PMC11195532 DOI: 10.1111/bjh.18498] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/08/2022] [Accepted: 09/21/2022] [Indexed: 12/05/2022]
Abstract
Burkitt lymphoma arising in paediatric post-solid-organ transplantation-Burkitt lymphoma (PSOT-BL) is a clinically aggressive malignancy and a rare form of post-transplant lymphoproliferative disorder (PTLD). We evaluated 35 patients diagnosed with PSOT-BL at 14 paediatric medical centres in the United States. Median age at organ transplantation was 2.0 years (range: 0.1-14) and age at PSOT-BL diagnosis was 8.0 years (range: 1-17). All but one patient had late onset of PSOT-BL (≥2 years post-transplant), with a median interval from transplant to PSOT-BL diagnosis of 4.0 years (range: 0.4-12). Heart (n = 18 [51.4%]) and liver (n = 13 [37.1%]) were the most frequently transplanted organs. No patients had loss of graft or treatment-related mortality. A variety of treatment regimens were used, led by intensive Burkitt lymphoma-specific French-American-British/Lymphomes Malins B (FAB/LMB), n = 13 (37.1%), and a low-intensity regimen consisting of cyclophosphamide, prednisone and rituximab (CPR) n = 12 (34.3%). Median follow-up was 6.7 years (range: 0.5-17). Three-year event-free and overall survival were 66.2% and 88.0%, respectively. Outcomes of PSOT-BL patients receiving BL-specific intensive regimens are comparable to reported BL outcomes in immunocompetent children. Multi-institutional collaboration is feasible and provides the basis of prospective data collection to determine the optimal treatment regimen for PSOT-BL.
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Affiliation(s)
- Zeinab Afify
- Pediatric Hematology Oncology, Primary Children’s Med. Ctr, Salt Lake City, Utah, USA
| | - Manuela Orjuela-G rimm
- Division of Pediatric Hematology Oncology and Stem Cell Transplantation, and Department of Epidemiology, Columbia University Medical Center, New York, New York City, USA
| | | | - Mansi Dalal
- University of Florida, Gainesville, Florida, USA
| | - James B. Ford
- University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Pallavi Pillai
- Mount Sinai Kravis Children’s Hospital, New York, New York City, USA
| | - Joanna M. Robles
- Department of Pediatrics, Division of Hematology/Oncology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sonika Reddy
- Division of Pediatric Hematology Oncology and Stem Cell Transplantation, and Department of Epidemiology, Columbia University Medical Center, New York, New York City, USA
| | - Sarah McCormack
- Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical center, Cincinnati, Ohio, USA
- Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | | | - Tonya Ureda
- Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Warren Alperstein
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Holly Edington
- Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Tamara P. Miller
- Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jeremy D. Rubinstein
- Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical center, Cincinnati, Ohio, USA
- Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Madison Kavanaugh
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrew J. Bukowinski
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Erika Friehling
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Julie M. Rivers
- Department of Pediatrics, Seattle Children’s Hospital, Seattle, Washington, USA
| | - Karen M. Chisholm
- Department of Laboratories, Seattle Children’s Hospital, Seattle, Washington, USA
| | - Lianna J. Marks
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Clinton C. Mason
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, University of Utah, Salt Lake City, Utah, USA
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