Post-Transplantation Lymphoproliferative Disorders (PTLD) Definition: Lymphoid and/or plasmacytic proliferations that occur as a result of immunosuppression in the setting of solid organ or allogeneic hematopoietic cell transplantation Epidemiology: Lymphoma accounts for 21% of all cancers in recipients of solid-organ transplants, as compared with 4% among women and 5% among men in an immunocompetent population Risk Factors by transplant type: • Solid organ transplant: Type of organ transplanted (higher incidence in lung>heart>liver>kidney), EBV mismatch, intensity of induction and duration of immunosuppressive therapy • Allogeneic HSCT: Type of donor or donation (higher incidence in haploidentical>unrelated>HLA identical related), recipient age >50, Conditioning regimen Signs/Symptoms: Typically adenopathy, B symptoms, unexplained hematologic or biochemical abnormalities (↑ LDH), rising EBV viral load, signs/symptoms 2/2 infiltration of extralymphatic tissues Diagnosis and classification: tissue biopsy (preferably excisional) Up to 50% of PTLD cases that develop after solid-organ transplantation are not associated with EBV Nicholas J Thomas @nickthomasmed #PTLD #Post #Transplantation #Lymphoproliferative #Disorders #oncology #diagnosis #management #transplant
