文章：

实体器官移植受者中PTLD的发生是否与器官类型相关？一项关于风险与预后因素的多中心观察性研究

Does the Organ Matter in PTLD Development in Solid Organ Transplant Recipients? A Multicenter Observational Study of Risk and Prognostic Factors

原文发布日期：25 May 2025

DOI: 10.3390/cancers17111770

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: The risk of post-transplantation lymphoproliferative disorder (PTLD) varies according to the type of transplanted organ. To investigate the factors contributing to PTLD development and treatment outcomes, we established a multicenter registry that included patients diagnosed with PTLD within a population of 13,263 kidney, liver, and lung transplant recipients (KTRs, LTRs, and LngTRs, respectively), observed in a period between 2000 and 2023. Methods: The chi-squared test was used to analyze differences in group composition. Univariate and multivariate Cox regression were applied to determine the impact of factors upon PTLD onset and patient survival. Results: Our registry included 58 out of 9432 KTRs, 40 out of 3500 LTRs, and 5 out of 331 LngTRs. The median time to PTLD onset was significantly longer among KTRs (117 months post-transplant) than among LTRs (49 months,p< 0.001) and LngTRs (5 months,p< 0.001). LTRs treated with tacrolimus developed PTLD later compared to LTRs treated with cyclosporin (p= 0.042). In multivariate analysis, older age at first transplantation correlated with earlier disease development in SOTRs (HR = 1.03,p= 0.006) and KTRs (HR = 1.04,p= 0.003). Older age at first transplantation was also associated with worse survival among KTRs (p= 0.045). Conclusions: We identified clear differences in the factors affecting PTLD onset and survival between KTRs and LTRs. Organ-specific analyses are needed to improve our understanding of PTLD risk factors, treatment choices, and clinical outcomes.

摘要翻译： 

背景/目的：移植后淋巴组织增生性疾病（PTLD）的风险因移植器官类型而异。为探究PTLD发生的影响因素及治疗结局，我们建立了一个多中心登记系统，纳入了2000年至2023年间13,263例肾移植、肝移植和肺移植受者（分别为KTRs、LTRs和LngTRs）中被诊断为PTLD的患者。方法：采用卡方检验分析组间构成差异，通过单变量及多变量Cox回归分析各因素对PTLD发病及患者生存的影响。结果：登记系统共纳入9432例KTRs中的58例、3500例LTRs中的40例及331例LngTRs中的5例。KTRs发生PTLD的中位时间（移植后117个月）显著长于LTRs（49个月，p<0.001）和LngTRs（5个月，p<0.001）。使用他克莫司治疗的LTRs较使用环孢素者更晚发生PTLD（p=0.042）。多变量分析显示，在实体器官移植受者（HR=1.03，p=0.006）和KTRs（HR=1.04，p=0.003）中，首次移植年龄较大与PTLD更早发生相关。在KTRs中，首次移植年龄较大还与较差的生存率相关（p=0.045）。结论：我们发现影响KTRs和LTRs发生PTLD及生存的因素存在明显差异。需开展器官特异性分析以深化对PTLD危险因素、治疗选择及临床结局的理解。

原文链接：

Does the Organ Matter in PTLD Development in Solid Organ Transplant Recipients? A Multicenter Observational Study of Risk and Prognostic Factors