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Posttransplant lymphoproliferative disorder.

Matthew J Everly1, Roy D Bloom, Donald E Tsai

  • 1University of Cincinnati, Cincinnati, OH 45267, USA. matthew_everly@yahoo.com

The Annals of Pharmacotherapy
|October 18, 2007
PubMed
Summary
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Posttransplant lymphoproliferative disorder (PTLD) affects 1-20% of transplant recipients. Early screening and adjusted immunosuppression can prevent PTLD, while individualized treatment is key if it develops.

Area of Science:

  • Transplant medicine
  • Oncology
  • Immunology

Background:

  • Posttransplant lymphoproliferative disorder (PTLD) is a significant complication following solid organ transplantation.
  • It arises due to the interplay between immunosuppression and Epstein-Barr virus (EBV) reactivation or primary infection.

Purpose of the Study:

  • To comprehensively review the pathogenesis, clinical features, diagnosis, risk factors, and management strategies for PTLD.
  • To inform clinicians on effective prevention and treatment approaches for PTLD.

Main Methods:

  • A systematic literature search of MEDLINE from 1966 to 2007 was conducted.
  • Included studies focused on pediatric and adult solid organ transplant recipients.
  • Data from selected articles and review papers were analyzed.

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Main Results:

  • PTLD incidence ranges from 1-20% in solid organ transplant recipients.
  • Key risk factors include EBV-negative serostatus, transplant type, immunosuppression intensity, and recipient age.
  • Variable presentation, from asymptomatic to nonspecific symptoms; prevention involves minimizing immunosuppression and using EBV-targeted antivirals.

Conclusions:

  • Proactive screening and careful balancing of immunosuppression intensity are crucial for PTLD risk reduction.
  • Individualized treatment plans, including immunosuppression reduction and targeted therapies, are essential for managing PTLD.