Monomorphic Post-Transplant Lymphoproliferative Disorder in Pediatric Solid Organ Transplant Recipients: Treatment Approach Across Canada

Abstract

There are no standardized pediatric treatment protocols for monomorphic post-transplant lymphoproliferative disorder (PTLD). We reviewed data from Canadian pediatric centers to determine patient characteristics, treatment approaches and outcomes. There were 55 eligible children diagnosed with monomorphic PTLD between January 2001-December 2021. Forty-nine (89%) underwent reduction of immunosuppression. The majority, 44 (80%), received rituximab, 40/44 (91%) with concurrent chemotherapy. A total of 46 (84%) children received chemotherapy: LMB-96 (48%) and low-dose cyclophosphamide with prednisone (30%) being the favored regimens. Projected 3-year event-free survival and overall survival was 62% and 77%, respectively. Approach to monomorphic PTLD treatment was relatively consistent across Canada.