Screening and Management of PTLD

Abstract

Posttransplant lymphoproliferative disorder (PTLD) represents a heterogeneous group of lymphoproliferative diseases occurring in the setting of immunosuppression following hematopoietic stem cells transplant and solid organ transplantation. Despite its overall low incidence, PTLD is a serious complication following transplantation, with a mortality rate as high as 50% in transplant recipients. Therefore, it is important to establish for each transplant recipient a personalized risk evaluation for the development of PTLD based on the determination of Epstein-Barr virus serostatus and viral load following the initiation of immunosuppression. Due to the dynamic progression of PTLD, reflected in the diverse pathological features, different therapeutic approaches have been used to treat this disorder. Moreover, new therapeutic strategies based on the administration of virus-specific cytotoxic T cells have been developed. In this review, we summarize the available data on screening and treatment to suggest a strategy to identify transplant recipients at a higher risk for PTLD development and to review the current therapeutic options for PTLD.

Case Report: Post-transplant lymphoproliferative disorder as a serious complication of vascularized composite allotransplantation

“…The mainstay of PTLD treatment is the reduction of immunosuppression with the primary goal of inducing remission with the preservation of transplanted tissue ( 25 ). This is typically achieved via the discontinuation of antimetabolic agents, such as mycophenolate or azathioprine, and a 50% reduction of calcineurin inhibitors.…”

The role of 18F-FDG PET/CT metabolic parameters in the differential diagnosis of post-transplant lymphoproliferative disorder after pediatric liver transplantation

“…Due to the significant differences in treatment methods for PTLD and non-PTLD lymphadenopathy, the differential diagnosis of PTLD and non-PTLD lymphadenopathy is crucial ( 10 , 11 ). The current diagnostic approach for PTLD relies on pathological examination ( 12 ).…”