International prognostic index, type of transplant and response to rituximab are key parameters to tailor treatment in adults with CD20-positive B cell PTLD: clues from the PTLD-1 trial

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
R TrappeGerman PTLD Study Group and the European PTLD Network

Abstract

Tailoring treatment by patient strata based on the risk of disease progression and treatment toxicity might improve outcomes of patients with posttransplant lymphoproliferative disorder (PTLD). We analysed the cohort of 70 patients treated in the international, multicenter phase II PTLD-1 trial (NCT01458548) to identify such factors. Of the previously published scoring systems in PTLD, the international prognostic index (IPI), the PTLD prognostic index and the Ghobrial score were predictive for overall survival. None of the scoring systems had a considerable effect on the risk for disease progression. Age and ECOG performance status were the baseline variables with the highest prognostic impact in the different scoring systems. Baseline variables not included in the scoring systems that had an impact on overall survival and disease progression were the type of transplant and the response to rituximab at interim staging. Thoracic organ transplant recipients who did not respond to rituximab monotherapy were at particularly high risk for death from disease progression with subsequent CHOP-based chemotherapy. Patients in complete remission after four courses of rituximab and patients in partial remission with low-risk IPI had a low...Continue Reading

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Citations

Mar 17, 2016·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·Silke HellmichMichael Hallek
Sep 19, 2015·Blood·Daan DierickxOlivier Gheysens
May 24, 2017·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Richard HeyesDavid G Lott
Nov 28, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Vikas R Dharnidharka
May 18, 2016·Nature Reviews. Disease Primers·Vikas R DharnidharkaSylvain Choquet
Jun 15, 2017·Transplantation·Puneet Sood, Sundaram Hariharan
Apr 1, 2020·World Journal of Transplantation·Fedaey AbbasAhmed Halawa
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Jan 31, 2019·Cancer Medicine·Vikas R DharnidharkaKristine Wylie
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