Burkitt’s Lymphoma Post Renal Transplantation: PTLD.Int Survey

Burkitt‘s lymphoma is a well known type of malignant lymphoma in thegeneral population; but in transplant era, it has not been defined as a distinct category of posttransplant lymphoproliferative disorders (PTLD), possibly due to the very rare nature of thisdisease type in this population. In this first study, however, we aimed to find individual casesof Burkitt’s lymphomas reported by different series in the literature, and to compare theirdisease characters, behavior and prognosis with other PTLD patients reported by the samestudies.Methods: A comprehensive search of the current literature was performed through Pubmedand Google Scholar for reports or series including individual cases of Burkitt’s lymphomasdeveloping post renal transplantation. Overall 23 cases of Burkitt’s PTLD were found whosedata were compared to 103 renal transplant patients with other PTLD types.Immunosuppression types were comparable between the two groups (p=0.922).Results: Burkitt’s PTLD were significantly more likely to occur in the paediatric age (vs.adults; 41% vs. 13%, respectively; p=0.005); and as late onset disease (>1 yearposttransplant; 100% vs. 81%; p=0.035). Multi-organ PTLD (53% vs. 15%, respectively;p=0.004), Bone marrow complication (26% vs. 2%, respectively; p=0.003) and livermetastasis (12.5% vs. 0; p=0.043) were more frequently seen in the Burkitt’s PTLD group.Time interval from transplantation to PTLD development and survival of the patients werecomparable between the two groups.Conclusions: Burkitt’s lymphoma in renal transplant recipients is more likely to complicatechildren and to develop metastatic disease, especially within the bone marrow and the liver.So it is recommended to evaluate renal recipients whose PTLD lesions werehistopathologically defined as Burkitt’s lymphoma, for potential metastatic lesionsespecially within the liver and/or bone marrow. Prospective studies are suggested forconfirming these results.

Keywords:

Burkitt , Lymphoma , Renal , Transplantation , PTLD , Survey