Abstract: SA-PO038
Solid Organ Transplantation and Mortality Following Diffuse Large B Cell Lymphoma
Session Information
- Transplantation: Clinical Outcomes
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1802 Transplantation: Clinical
Authors
- Kizilbash, Sarah J., University of Minnesota, Minneapolis, Minnesota, United States
- Richardson, Michaela R., University of Minnesota, Minneapolis, Minnesota, United States
- Snyder, Jon J., Minneapolis Medical Research Foundation, Minneapolis, Minnesota, United States
- Kasiske, Bertram L., Hennepin County Medical Center, Minneapolis, Minnesota, United States
- Engels, Eric A., National Cancer Institute, Bethesda, Maryland, United States
- Israni, Ajay K., Hennepin County Medical Center, Minneapolis, Minnesota, United States
Background
Diffuse large B cell lymphoma (DLBCL) is a common malignancy in all age groups after solid organ transplant. The effects of prior transplant on mortality following DLBCL and the effect modification by age at diagnosis have not been described.
Methods
We used 11 state cancer registries to identify all DLBCL cases in those states and ascertained history of organ transplant through a linkage to the Scientific Registry of Transplant Recipients. We used a Cox proportional hazard model to examine the effect of transplant on mortality after adjusting for age at DLBCL diagnosis, sex, race, year of diagnosis, site of DLBCL, stage of cancer at diagnosis and treatment. We also investigated an interaction between age at diagnosis and transplant status.
Results
Our cohort included 1,338 DLBCL cases with prior organ transplant and 132,713 without. Compared with non-transplant patients, transplant recipients had lower mean age at diagnosis (48.5 vs. 62.4 years, p <0.0001), male preponderance (67.5 vs. 53.3%, p <0.0001), higher incidence of extranodal disease (49.7 vs. 37.5%, p <0.0001), and higher prevalence of distant stage at diagnosis (47.5 vs. 43%, p <0.0001). After multivariate adjustment, overall (adjusted hazard ratio (aHR): 1.83, 95% CI: 1.71-1.96) and cancer-specific mortality (aHR: 1.21, 95% CI: 1.1-1.33) were higher in transplant recipients than in non-transplant patients. The effect of transplant on mortality following DLBCL was highest in patients aged younger than 20 years at diagnosis (Figure).
Conclusion
Prior organ transplant is associated with an increased risk of overall and cancer-specific mortality following DLBCL. The effect of transplant on mortality is highest in DLBCL patients aged younger than 20 years at diagnosis.
Overall mortality of patients with DLBCL with prior organ transplant compared to those without