Definition
Iatrogenic immunodeficiency-associated lymphoproliferative disorders can be defined as lymphoid proliferations, plasmacytic proliferations, or lymphomas that arise as a consequence of iatrogenic immunosuppression. Such disorders are divided into posttransplant lymphoproliferative disorders (PTLD) arising in patients treated with immunosuppressive therapy for solid organ, bone marrow, or stem cell transplant and other iatrogenic immunodeficiency-associated lymphoproliferative disorders arising in patients treated with immunosuppressive drugs for autoimmune disease or conditions other than transplant (Bagg and Dunphy 2013; Gaulard et al. 2017; Swerdlow et al. 2017; Tsao and Hsi 2007). Immunosuppressive drugs reported as associated with lymphoproliferative disorders and lymphomas include methotrexate and antitumor necrosis factor alpha (anti-TNFα) therapy (e.g., infliximab, adalimumab, etanercept). These lymphoproliferative disorders are less well defined than PTLD.
Clinical...
References and Further Reading
Bagg, A., & Dunphy, C. H. (2013). Immunosuppressive and immunomodulatory therapy-associated lymphoproliferative disorders. Seminars in Diagnostic Pathology, 30(2), 102–112. https://doi.org/10.1053/j.semdp.2012.08.005.
Courville, E. L., Yohe, S., Chou, D., Nardi, V., Lazaryan, A., Thakral, B., et al. (2016). EBV-negative monomorphic B-cell post-transplant lymphoproliferative disorders are pathologically distinct from EBV-positive cases and frequently contain TP53 mutations. Modern Pathology, 29(10), 1200–1211. https://doi.org/10.1038/modpathol.2016.130.
Deepak, P., Sifuentes, H., Sherid, M., Stobaugh, D., Sadozai, Y., & Ehrenpreis, E. D. (2013). T-cell non-Hodgkin’s lymphomas reported to the FDA AERS with tumor necrosis factor-alpha (TNF-alpha) inhibitors: Results of the REFURBISH study. The American Journal of Gastroenterology, 108(1), 99–105. https://doi.org/10.1038/ajg.2012.334.
Dojcinov, S. D., Venkataraman, G., Raffeld, M., Pittaluga, S., & Jaffe, E. S. (2010). EBV positive mucocutaneous ulcer – a study of 26 cases associated with various sources of immunosuppression. The American Journal of Surgical Pathology, 34(3), 405–417. https://doi.org/10.1097/PAS.0b013e3181cf8622.
Gaulard, P., Swerdlow, S. H., Harris, N. L., Sundstrom, C., & Jaffe, E. S. (2017). Other iatrogenic immunodeficiency-associated lymphoproliferative disorders. In S. H. Swerdlow, E. Campo, N. L. Harris, E. S. Jaffe, S. A. Pileri, H. Stein, & J. Thiele (Eds.), WHO classification of tumours of haematopoietic and lymphoid tissues (Revised 4th ed., pp. 462–464). Lyon: IARC.
Gibson, S. E., Swerdlow, S. H., Craig, F. E., Surti, U., Cook, J. R., Nalesnik, M. A., … & Bacon, C. M. (2011). EBV-positive extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue in the posttransplant setting: A distinct type of posttransplant lymphoproliferative disorder? The American Journal of Surgical Pathology, 35(6), 807–815. https://doi.org/10.1097/PAS.0b013e3182190999.
Hasserjian, R. P., Chen, S., Perkins, S. L., de Leval, L., Kinney, M. C., Barry, T. S., … & O’Malley, D. P. (2009). Immunomodulator agent-related lymphoproliferative disorders. Modern Pathology, 22(12), 1532–1540. https://doi.org/10.1038/modpathol.2009.131.
Luskin, M. R., Heil, D. S., Tan, K. S., Choi, S., Stadtmauer, E. A., Schuster, S. J., … & Reshef, R. (2015). The impact of EBV status on characteristics and outcomes of posttransplantation lymphoproliferative disorder. American Journal of Transplantation, 15(10), 2665–2673. https://doi.org/10.1111/ajt.13324.
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Swerdlow, S. H., Webber, S. A., Chadburn, A., & Ferry, J. A. (2017). Post-transplant lymphoproliferative disorders. In S. H. Swerdlow, E. Campo, N. L. Harris, E. S. Jaffe, S. A. Pileri, H. Stein, & J. Thiele (Eds.), WHO classification of tumours of haematopoietic and lymphoid tissues (Revised 4th ed., pp. 453–462). Lyon: IARC.
Tsao, L., & Hsi, E. D. (2007). The clinicopathologic spectrum of posttransplantation lymphoproliferative disorders. Archives of Pathology & Laboratory Medicine, 131(8), 1209–1218. https://doi.org/10.1043/1543-2165(2007)131[1209:TCSOPL]2.0.CO;2.
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Courville, E.L., Sohani, A.R. (2018). Iatrogenic Immunodeficiency Associated Lymphoproliferative Disorders. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_4772-1
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