Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients
Post-transplant lymphoproliferative disease (PTLD) is a well-recognized complication after transplant. This study aimed to develop and validate a risk score to predict PTLD among solid organ transplant (SOT) recipients. Poisson regression identified predictors of PTLD with the best fitting model sel...
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| Format: | Article |
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MDPI AG
2022-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/13/3279 |
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| author | Quenia dos Santos Neval Ete Wareham Amanda Mocroft Allan Rasmussen Finn Gustafsson Michael Perch Søren Schwartz Sørensen Oriol Manuel Nicolas J. Müller Jens Lundgren Joanne Reekie |
| author_facet | Quenia dos Santos Neval Ete Wareham Amanda Mocroft Allan Rasmussen Finn Gustafsson Michael Perch Søren Schwartz Sørensen Oriol Manuel Nicolas J. Müller Jens Lundgren Joanne Reekie |
| author_sort | Quenia dos Santos |
| collection | DOAJ |
| description | Post-transplant lymphoproliferative disease (PTLD) is a well-recognized complication after transplant. This study aimed to develop and validate a risk score to predict PTLD among solid organ transplant (SOT) recipients. Poisson regression identified predictors of PTLD with the best fitting model selected for the risk score. The derivation cohort consisted of 2546 SOT recipients transpanted at Rigshospitalet, Copenhagen between 2004 and 2019; 57 developed PTLD. Predictors of PTLD were high-risk pre-transplant Epstein–Barr Virus (EBV), IgG donor/recipient serostatus, and current positive plasma EBV DNA, abnormal hemoglobin and C-reactive protein levels. Individuals in the high-risk group had almost 7 times higher incidence of PTLD (incidence rate ratio (IRR) 6.75; 95% CI: 4.00–11.41) compared to the low-risk group. In the validation cohort of 1611 SOT recipients from the University Hospital of Zürich, 24 developed PTLD. A similar 7 times higher risk of PTLD was observed in the high-risk group compared to the low-risk group (IRR 7.17, 95% CI: 3.05–16.82). The discriminatory ability was also similar in derivation (Harrell’s C-statistic of 0.82 95% CI (0.76–0.88) and validation (0.82, 95% CI:0.72–0.92) cohorts. The risk score had a good discriminatory ability in both cohorts and helped to identify patients with higher risk of developing PTLD. |
| first_indexed | 2024-03-09T22:02:52Z |
| format | Article |
| id | doaj.art-be8e63209ae74248b7695d64debb5c06 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T22:02:52Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-be8e63209ae74248b7695d64debb5c062023-11-23T19:47:18ZengMDPI AGCancers2072-66942022-07-011413327910.3390/cancers14133279Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant RecipientsQuenia dos Santos0Neval Ete Wareham1Amanda Mocroft2Allan Rasmussen3Finn Gustafsson4Michael Perch5Søren Schwartz Sørensen6Oriol Manuel7Nicolas J. Müller8Jens Lundgren9Joanne Reekie10Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, 2100 Copenhagen, DenmarkCentre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, 2100 Copenhagen, DenmarkCentre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, 2100 Copenhagen, DenmarkDepartment of Surgical Gastroenterology, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, Section for Lung Transplantation, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, Section for Lung Transplantation, Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Nephrology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, DenmarkInfectious Diseases Service and Transplantation Center, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Swiss Transplant Cohort Study, 8091 Zürich, SwitzerlandCentre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, 2100 Copenhagen, DenmarkCentre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, 2100 Copenhagen, DenmarkPost-transplant lymphoproliferative disease (PTLD) is a well-recognized complication after transplant. This study aimed to develop and validate a risk score to predict PTLD among solid organ transplant (SOT) recipients. Poisson regression identified predictors of PTLD with the best fitting model selected for the risk score. The derivation cohort consisted of 2546 SOT recipients transpanted at Rigshospitalet, Copenhagen between 2004 and 2019; 57 developed PTLD. Predictors of PTLD were high-risk pre-transplant Epstein–Barr Virus (EBV), IgG donor/recipient serostatus, and current positive plasma EBV DNA, abnormal hemoglobin and C-reactive protein levels. Individuals in the high-risk group had almost 7 times higher incidence of PTLD (incidence rate ratio (IRR) 6.75; 95% CI: 4.00–11.41) compared to the low-risk group. In the validation cohort of 1611 SOT recipients from the University Hospital of Zürich, 24 developed PTLD. A similar 7 times higher risk of PTLD was observed in the high-risk group compared to the low-risk group (IRR 7.17, 95% CI: 3.05–16.82). The discriminatory ability was also similar in derivation (Harrell’s C-statistic of 0.82 95% CI (0.76–0.88) and validation (0.82, 95% CI:0.72–0.92) cohorts. The risk score had a good discriminatory ability in both cohorts and helped to identify patients with higher risk of developing PTLD.https://www.mdpi.com/2072-6694/14/13/3279transplantationEBV DNAPTLDSOT |
| spellingShingle | Quenia dos Santos Neval Ete Wareham Amanda Mocroft Allan Rasmussen Finn Gustafsson Michael Perch Søren Schwartz Sørensen Oriol Manuel Nicolas J. Müller Jens Lundgren Joanne Reekie Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients Cancers transplantation EBV DNA PTLD SOT |
| title | Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients |
| title_full | Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients |
| title_fullStr | Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients |
| title_full_unstemmed | Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients |
| title_short | Development and Validation of a Risk Score for Post-Transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients |
| title_sort | development and validation of a risk score for post transplant lymphoproliferative disorders among solid organ transplant recipients |
| topic | transplantation EBV DNA PTLD SOT |
| url | https://www.mdpi.com/2072-6694/14/13/3279 |
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