Bone marrow findings of 23 Korean post-transplant lymphoproliferative disorder patients: a single-center experience

Work-up of post-transplant lymphoproliferative disorders (PTLDs) often involves bone marrow (BM) examinations. We evaluated 23 transplant patients with PTLDs to investigate incidence of BM involvement and associated morphologic changes as well as prognosis.

We retrospectively assessed BM findings of 23 transplant patients with PTLDs who had undergone BM staging at Seoul Asan Medical Center from 1994 to 2010.

Four (17%) showed BM involvement of PTLDs, including two pathologically diagnosed with PTLD by liver and skin biopsy and two diagnosed by BM examination. PTLD subtypes in four patients were all monomorphic, with one each having plasma cell myeloma, diffuse large B cell lymphoma, monomorphic B cell lineage, and monomorphic T-cell lineage. Epstein-Barr virus (EBV) in situ hybridization showed 11 of 23 (47.8%) patients were EBV positive, including two patients with BM involvement, one each with plasma cell myeloma and monomorphic T-cell lineage. Epstein-Barr virus infection was observed in nine of 19 patients (39.1%) without BM involvement or morphologic abnormalities. Mortality rate was higher in patients with than without BM involvement (p = 0.050).

High incidence of BM involvement in patients with PTLD and high mortality rates of these patients suggest BM examination study may be important in diagnosis and staging work-up of PTLD.