Post-solid organ transplant cutaneous T-cell lymphoma: A systematic review of the literature

Solid organ transplant (SOT) recipients have a higher chance of developing cancers due to immunosuppressive therapy. Among post-SOT skin cancers, the most common is squamous cell carcinoma, while post-transplant cutaneous T-cell lymphoma (PT-CTCL) is less known because of its rare prevalence. Understanding PT-CTCL is important to improve therapeutic approaches and aftercare in these patients. To evaluate manifestations, characteristics, management strategies, and outcomes of PT-PTCL in SOT patients, a systematic search was conducted through PubMed/Medline, Scopus, Web of Science, and Embase until July 28th, 2024. Inclusion criteria were centered around the new onset of CTCL after organ transplantation. Following PRISMA guidelines, 50 studies including 111 patients were included. Most patients who developed PT-PTCL were males (79.3%), and the mean age was 51.9. Kidney transplantation was the most frequent transplant type among patients who developed PT-CTCL (60.4%). This was followed by the heart (17.1%), liver (17.1%), and lung (2.7%). Among 105 patients with available data, complete remission was achieved for 42 (39.6%), and partial response was observed in 13 (12.3%). PT-PTCL is associated with prolonged immunosuppressive therapy. Personalized treatment and modifications to immunosuppression regimens are critical. Further research into immunological and molecular pathways is essential to achieve better management approaches.