Tae Yeon Jeon MD, Presenter: Nothing to Disclose

Ji Hye Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

Hong Eo, Abstract Co-Author: Nothing to Disclose

So Young Yoo MD, Abstract Co-Author: Nothing to Disclose

Hee Jung Kim, Abstract Co-Author: Nothing to Disclose

Keon Hee Yoo MD, Abstract Co-Author: Nothing to Disclose

Gye Yeon Lim MD, Abstract Co-Author: Nothing to Disclose

Jung Eun Cheon MD, Abstract Co-Author: Nothing to Disclose

Woo Sun Kim MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To describe clinical and imaging features of posttransplantation lymphoproliferative disorder (PTLD) in pediatric hematopoietic stem cell transplantation (HSCT) in comparison with PTLD associated with liver transplantation (LT).

We retrospectively reviewed medical records and images of a total of 39 pediatric patients with pathologically proven PTLD after HSCT (n=16) or LT (n=23). We compared overall incidence, clinical course, histopathological types, and imaging findings between two groups of PTLDs. The χ2 or Fisher’s exact test was used for statistical analysis.

Overall incidence of PTLD was 3% in HSCT (12% in umbilical cord blood transplantation (UCBT)) and 12% in LT. PTLD occurred within 6 months following the transplantation in 12 (75%) stem cell recipients and in 9 (39%) liver recipients (P < .05). Most (87%) of the HSCT recipients were treated using anti-thymocyte globulin. Histopathological examination revealed monomorphic type in 10 (63%) stem cell recipients and 7 (30%) liver recipients (P = .059). Imaging showed multi-organ involvement in 12 (75%) stem cell recipients and 8 (35%) liver recipients (P < .05). PTLD was localized in the abdomen in 20 (87%) liver recipients whereas 11 (69%) stem cell recipients exhibited extra-abdominal PTLD (P < .05). Extra-nodal involvement was common in both groups (76% and 83% each). Imaging appearance was not significantly different except that bilateral involvement was common in renal and adrenal PTLDs associated with HSCT. Eleven (69%) patients with HSCT related PTLD demonstrated response after treatment and fulminant course killed 3 patients. PTLD after LT improved in 16 (96%) of the 17 followed patients after treatment and all were alive.

PTLD developed more frequently after UCBT in children than has been known before. PTLD after HSCT exhibited earlier onset, more disseminated disease, less treatment response, and worse outcome compared with LT related PTLD.

UCBT related PTLD increasingly occurs than has been known before, possibly related with T cell depletion. HSCT related PTLD tends to occur earlier with aggressive clinical course than PTLD after LT.

Jeon, T, Kim, J, Eo, H, Yoo, S, Kim, H, Yoo, K, Lim, G, Cheon, J, Kim, W, et al, , et al, , Posttransplantation Lymphoproliferative Disorder in Children: Manifestations in Hematopoietic Stem Cell Recipients in Comparison with Liver Recipients.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005910.html