Lymphoma in the immunosuppressed

Michele Spina, Robert Marcus, Umberto Tirelli

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Introduction Immunodepleted patients are at higher risk for developing lymphoproliferative disorders (LPD), above all non-Hodgkin's lymphomas (NHL). Even though the association between primary immunodeficiency diseases (e.g. X-linked lymphoproliferative syndrome, common variable immunodeficiency, ataxia telangiectasia and Wiskott–Aldrich syndrome) and LPDs, on the one hand, and between LPDs and autoimmune diseases, on the other, is well known, the leading causes of immunosuppression are considered at present to be organ transplantation and HIV infection. Generally, lymphomas in immunocompromised hosts differ from lymphomas in the general population in histopathological findings, increased extranodal involvement, a more aggressive clinical course, poorer response to conventional therapies and poorer outcome. In patients who undergo solid-organ transplantation, the risk for lymphoma is strongly influenced by the type of organ transplanted: during the first year after kidney or heart transplantation it is 20 and 120 times higher, respectively, than in the general population. The majority of lymphomas develop within the first three months after transplantation, even if some cases are reported after prolonged immunodepression. Overall the risk of cancer in organ-transplant recipients is well known: the frequency of cancer after renal transplantation was reported to be 6% in the United States and 8.3% in the Nordic countries, that is 4.5–6.3 times higher than in the general population. In a large series of 1844 renal-transplant recipients in Italy a significantly increased incidence of Kaposi's sarcoma, cancers of the lip, liver and kidney, and NHL was observed. The incidence of HIV-related NHLs (HIV-NHL) has increased since 1981.

Original languageEnglish
Title of host publicationLymphoma: Pathology, Diagnosis and Treatment
PublisherCambridge University Press
Pages252-265
Number of pages14
ISBN (Print)9780511663369, 9780521865449
DOIs
Publication statusPublished - Jan 1 2007

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Lymphoma in the immunosuppressed'. Together they form a unique fingerprint.

  • Cite this

    Spina, M., Marcus, R., & Tirelli, U. (2007). Lymphoma in the immunosuppressed. In Lymphoma: Pathology, Diagnosis and Treatment (pp. 252-265). Cambridge University Press. https://doi.org/10.1017/CBO9780511663369.018