A64 BURKITT LYMPHOMA AFTER PEDIATRIC LIVER TRANSPLANTATION
Bibliographic record
Abstract
Burkitt lymphoma (BL) is a post-transplant lymphoproliferative disorder (PTLD) different from other monomorphic PTLDs (M-PTLDs). We report clinical presentation and pathologic findings in 6 pediatric cases. We included patients that undergone a liver transplantation (LT) at Sainte Justine Hospital (Montreal) or in The Children hospital of Lyon, from 1991 to 2017, (aged ≤18 years). During this period, 10 patients presented monomorphic PTLDs (M-PTLDs), 6 of which were Burkitt lymphoma (BL). The median age at transplantation, for the 6 children (5 boys, 1 girls) with BL, was 21.5 months (range 6 – 159 months), and biliary atresia was the main indication (3/6). BL had an abdominal presentation in majority of cases (5/6). Patients displayed a monomorphic population of small to intermediate-sized, non-cleaved, lymphoid elements with a “starry-sky” pattern. The immune-phenotype in patients available for analysis was CD20+ (n =6/6), CD10+ (n = 6/6), Bcl-6+ (n = 6/6), Ki-67/MIB-1 proliferation index (n = 5/5), and negative for TdT (n = 5/5). Pre-transplant Epstein-Barr virus serology was negative in 4 patients (n = 4/6). At the time of BL diagnosis, all patients showed high EBV viral loads estimated by quantitative PCR testing between 16000 and 206 copies/ ml. The PCR was positive since a median time of 26.5 months (range, 1–40 months). The median time from transplantation to diagnosis was 33 months (range, 3–46 months). All patients were currently alive after chemotherapy, with median disease-free time of 14.5 years from diagnosis (range, 2–19 years). Post-transplant-BL is strongly associated with high EBV viral loads and represented a distinct monomorphic PTLD. Managed aggressively with decreased immunosuppression and specific chemotherapy must lead to a favorable outcome. These data also lead to discuss the modality of monitoring and the establishment of early treatment, with anti CD 20, for transplanted patients who retain high EBV viral loads. Ste Justine Foundation, Servier Laboratory
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".