| While recent studies and trials in post-transplant lymphoproliferative disorders (PTLD) have yielded important information regarding treatment and prognosis, relatively little is known about the rare subtypes plasmacytoma and plasma cell myeloma PTLD (PTLD-MM).;Patients were identified in the Scientific Registry of Transplant Recipients between 1999-2011, overall survival (OS) estimated, and treatment trends evaluated. The effects of patient characteristics on OS were evaluated with Cox proportional hazards models. OS in PTLD-MM was compared to matched controls with multiple myeloma (MM) from the Surveillance, Epidemiology and End Results program.;214 patients with PTLD-MM were identified. Median OS in the whole cohort was 2.4 years. Median OS had not been reached in those diagnosed later in the study period, compared to 2, Caucasian race and the use of OKT3 as an induction immunosuppressive agent were statistically significantly associated with diminished survival; extramedullary disease and poor performance status were nearly significant. When compared to matched controls, OS in PTLD-MM is worse than in MM (aHR 1.6, p<0.001), though improvement in OS over the last decade are more pronounced in PTLD-MM than in MM (p for interaction 0.02).;Age at diagnosis, elevated creatinine, race and OKT3 were all associated with worse survival in patients with PTLD-MM. In contrast to prior studies, extramedullary disease was associated with increased risk of death. PTLD-MM is a rare disorder with poor prognosis, though dramatic improvements in OS over the last decade have outstripped those made in MM over the same time period. |
