Читать книгу Blood and Marrow Transplantation Long Term Management - Группа авторов - Страница 157

Posttransplant lymphoproliferative disorders (PTLD) are the most common secondary malignancy in the first year after allogeneic HSCT. Most of these cases are related to compromise immune function and Epstein‐Barr virus (EBV) reactivation. The large majority of the PTLD have a B‐cell origin, though some T‐cell PTLDs have been described [54, 55].

Nevertheless, several cases of late‐occurring lymphomas have been reported in the literature. It is believed that these late‐occurring lymphomas represent an entity that is distinct from the early‐occurring B‐cell PTLD [56–59].

“Secondary” Hodgkin disease (HD) has also been observed among HSCT recipients. HSCT recipients followed as part of a large cohort study were at a six‐fold increased risk of developing HD when compared with the general population [60]. Most of the reported cases were of the mixed cellularity subtype, and most of these cases contained the EBV genome. These cases differed from the EBV‐associated PTLD by the absence of risk factors commonly associated with EBV‐associated PTLD, by a later onset (>2.5 years), and relatively good prognosis. The increased incidence of HD among HSCT recipients could possibly be explained by exposure to EBV and over‐stimulation of cell‐mediated immunity, but no clear evidence for a link with cGVHD has been established.