How I treat posttransplant lymphoproliferative disorders

Area of Science:

• Immunology
• Oncology
• Transplantation

Background:

• Posttransplant lymphoproliferative disorder (PTLD) is a serious complication following solid organ or hematopoietic stem cell transplantation.
• Impaired immune surveillance and Epstein-Barr virus (EBV) infection/reactivation are central to PTLD development.

Observation:

• PTLD diagnosis and treatment are complex due to its rarity, diverse morphology, and confounding factors like underlying immune status and graft type.
• This article utilizes two case reports to explore specific challenges and novel perspectives in PTLD management.

Findings:

• Key challenges include the wide spectrum of PTLD presentations, impacting treatment optimization.
• The significant role of EBV in PTLD pathogenesis and clinical course is highlighted.
• Controversial aspects of treating Burkitt lymphoma (BL)-PTLD are discussed.

Implications:

• Provides practical insights for clinicians and pathologists managing PTLD.
• Addresses knowledge gaps and offers new perspectives on PTLD pathogenesis and treatment strategies.
• Emphasizes the need for tailored approaches considering EBV status and specific PTLD subtypes.