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P8.085 Outcomes of Post Kidney Transplant Lymphoproliferative Disorder (PTLD)

Fatima AlKindi, United Arab Emirates

Internal Medicine
Tawam Hospital

Abstract

Outcomes of post kidney transplant lymphoproliferative disorder (PTLD)

Fatima AlKindi1, Arif Alam1, Mohammad Al Hakim 2, Ahmad Chaaban 2, Yousef Boobes 2.

1Internal Medicine, Tawam Hospital, AlAin, United Arab Emirates; 2Nephrology, Seha Kidney Care, AlAin, United Arab Emirates

Introduction: Common malignancies post kidney transplantation are non-melanotic skin cancer, Kaposi sarcoma and post-transplant lym­phoproliferative disorder (PTLD). We aim to study the outcomes of PTLD in KT recipient in oncology center in UAE.

Method: Ethical approval was obtained to conduct a retrospective chart review study at Tawam Hospital (January 2009 to 2021). We included adult kidney transplant recipients (age > 16) diagnosed with PTLD. Demographic, laboratory data and clinical outcomes were studied.

Result: 528 KT recipients were identified during the study period, and 6 patients (1.13%) were included. The mean age was 47.5 years, four females and two males. All the KT patients received transplantation from living donors and were on maintenance triple immunosuppressive (IS) medications prior to PTLD diagnosis. The comorbid conditions in our cohort were hypertension (100%), diabetes mellitus (50%), ischemic heart disease (33%), history of rejection (33%), hepatitis B virus (33%) and hemolytic uremic syndrome (16.6%). The types of PTLD (n=6) in our cohort were Diffuse large B-cell lymphoma (n=4), Anaplastic Large Cell Lymphoma of left breast (1), and H. pylori related gastric maltoma (n=1). The median diagnosis interval ranged between 3 to 27 years post transplantation. The medical management included reduction of IS medications in all patients (n=6), Four PTLD patients required chemotherapy R-CHOP and patient with gastric lymphoma was treated with H pylori eradication. One patient developed recurrence of lymphoma DLBCL at 30 years post kidney transplantation and was offered palliative care due to old age and comorbid conditions. Mortality rate was 33% (n=2) related to septic shock with gram-negative bacteremia.

Conclusion: The incidence of PTLD in our KT recipients over 10 years was 1.13 %. Late onset PTLD at 3 to 27 years were noted in our cohort, and recurrent disease is very rare.

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