Stoma formation after lymphoproliferative disorders and immunosuppression therapy

Post-transplant lymphoproliferative disorders (PTLD) are lymphomas that may arise in organ, bone marrow or stem cell transplant recipients who are taking immunosuppressive drugs to prevent rejection of the transplant. The likelihood of developing PTLD depends on the type of transplant. PTLD is a potentially severe complication of post-transplant treatment, with an uncertain prognosis. Lymphoproliferative disorders can also occur in people taking immunosuppressants for inflammatory bowel disease. This article will explore PTLD and discuss the experience of caring for patients who developed lymphoproliferative conditions and required emergency stoma formation. The emotional and physical impact of surgery upon these patients, who have already experienced a protracted treatment journey, will be explored. Implications for practice for the lymphoma team and stoma nurse specialists involved with the care of these patients will also be considered.