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Transplant recipients comprise substantial portion of non-Hodgkin lymphoma cases
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Solid organ transplant recipients made up a substantial and growing portion of children and adolescents with non-Hodgkin lymphoma, according to findings from a cohort study published in Cancer.
“Pediatric solid organ transplant recipients have a 100 to 200 times higher non-Hodgkin lymphoma risk than the general pediatric population,” Elizabeth L. Yanik, PhD, assistant professor of orthopaedic surgery at Washington University School of Medicine in St. Louis, and colleagues wrote. “Epstein-Barr virus can transform and immortalize B lymphocytes, and this can lead to the development of lymphoma.
Pediatric transplant recipients are at higher risk for non-Hodgkin lymphoma than the general population, which contributes to a higher incidence overall among U.S. children and adolescents.
Because the number of children and adolescents with functioning transplants continues to increase, the impact on non-Hodgkin lymphoma may grow.
The researchers used data linked from the U.S. transplant registry to 16 different cancer registries to perform a cohort study. Yanik and colleagues calculated cancer incidence rates for patients aged younger than 20 years in both the general population and among patients who had received solid organ transplants.
Approximately 22,270 cases of non-Hodgkin lymphoma occurred in children and adolescents between 1990 and 2012. Of these, 628 occurred in transplant recipients; transplant recipients accounted for 2.82% of non-Hodgkin lymphoma cases (95% CI, 2.45-3.19).
The most common subtypes of lymphoma among patients who received transplants were diffuse large B-cell lymphoma (DLBCL; 64.5%) and Burkitt lymphoma (8.6%). Overall, patients who had transplants contributed 7.62% (95% CI, 6.35-8.88) of DLBCL cases and 0.87% (95% CI, 0.51-1.23) of Burkitt lymphoma cases.
In transplant recipients, children aged younger than 5 years (4.46%; 95% CI, 3.24-5.69) and those who received transplants in more recent calendar years (3.73% in 2010-2012; 95% CI, 2.07-5.39) demonstrated the highest proportions of those who developed non-Hodgkin lymphoma.
Transplant recipients made up 19.78% (95% CI, 12.89-26.66) of DLBCL cases among children aged younger than 5 years and 11.4% (95% CI, 5.54-17.28) of DLBCL cases that occurred between 2010 and 2012.
“The proportion of non-Hodgkin lymphoma diagnoses attributable to transplant recipients has grown over time, and it is likely that this population will be an important source of pediatric non-Hodgkin lymphoma cases in the future,” the researchers wrote. “It would be beneficial for a portion of future efforts in pediatric lymphoma research to focus specifically on transplant recipients because this unique group may require prevention and treatment approaches that differ from those for the general population.” – by Andy Polhamus
Disclosures: Yanik reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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