Lymphoproliferative disorders in renal transplant patients in Japan

Post-transplantation lymphoproliferative disorders (PT-LPD) are characteriz ed by a clinically and morphologically heterogeneous group of lymphoid prol iferation occurring after organ or bone marrow transplantation. The immunod eficient state provides a basis for lymphomagenesis probably through activa tion of oncogenic viruses, Twenty-four patients in whom PT-LPD developed af ter renal transplantation in Japan were analyzed. They received hemodialysi s for 4 to 226 (median 13) months before transplantation. In situ hybridiza tion was performed to detect Epstein-Barr virus (EBV). Polymerase chain rea ction and Southern hybridization with primers in the tax and pol regions of human T-cell leukemia virus type I (HTLV-I) were performed on DNA extracte d from paraffin-embed;led specimens. Immunohistochemical analysis revealed that 12 cases were B-cell type, 10 cases (42%) T-cell type and 2 NK-cell ty pe. Five of the T-cell cases were classified as adult T-cell lymphoma with proven HTLV-I genome in the tumor and seropositivity for the virus. These c ases were classified as adult T-cell lymphoma (ALT), More than 80% of B cel l, 30% of T-cell and both NK/T-cell lymphomas were EBV-positive, Go-infecti on of EBV and HTLV-I was found in 2 cases with ATL, These findings showed t hat ATL is common among Japanese renal transplant patients, which might be due to transmission of HTLV-I via blood transfusion during hemodialysis. (C ) 2001 Wiley-Liss, Inc.