Array-CGH predicts prognosis in plasma cell post-transplantation lymphoproliferative disorders

Genes Chromosomes Cancer. 2017 Mar;56(3):221-230. doi: 10.1002/gcc.22428. Epub 2016 Nov 1.

Abstract

Plasma-cell post-transplantation lymphoproliferative disorder (PC-PTLD) is a rare monomorphic PTLD entity divided into plasma cell myeloma (PCM) and plasmacytoma-like lesion (PLL) PTLD. To date, there are no exhaustive published cytogenetic data on PC-PTLD. We report array-based comparative genomic hybridization (aCGH) of 10 cases of PCM and PLL-PTLD. Patients had received kidney (n = 6), heart (n = 2), lung (n = 1) or bone marrow (n = 1) transplantation. There were six men and median age at time of PTLD was 56.5 years (3-74). We identified two different cytological features, plasmacytic and plasmablastic, among six PLL and three PCM PTLD. Eight cases were associated with EBV. First line treatment was heterogeneous: rituximab alone (n = 5), CHOP-like (n = 3) and multiple myeloma-like (n = 1). One patient died before any treatment. After a median follow-up of 19.5 months (0-150), five patients died (four from PTLD) and five were alive without evidence of disease. By aCGH, 5/10 demonstrated a complex profile. The most frequent abnormalities were +7q (5/10), +16q (5/10), +17q (5/10), +17p (4/10), +5q (4/10), t7 (4/10), t9 (3/10), del1p (3/10). No del17p13 (TP53) were observed. Del1p32.3 (CDKN2C) was observed in 2 cases. On univariate prognostic analysis, a complex aCGH was associated with a shorter OS. Thus, cytogenetic abnormalities seem to be closely related to those reported in multiple myeloma or diffuse large B cell lymphoma. Complex aCGH constitutes an unfavorable prognostic marker and aCGH should be integrated in the evaluation of patients with PLL/PCM-PTLD. © 2016 Wiley Periodicals, Inc.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers, Tumor / genetics*
  • Child
  • Child, Preschool
  • Comparative Genomic Hybridization / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphoproliferative Disorders / diagnosis*
  • Lymphoproliferative Disorders / etiology
  • Lymphoproliferative Disorders / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Organ Transplantation / adverse effects*
  • Plasma Cells / pathology*
  • Prognosis
  • Retrospective Studies
  • Stem Cell Transplantation / adverse effects*
  • Survival Rate
  • Young Adult

Substances

  • Biomarkers, Tumor