Risk factors, diagnosis, and management of posttransplant lymphoproliferative disorder: improving patient outcomes with a multidisciplinary treatment approach

Characteristics, management, and outcome of pediatric patients with post‐transplant lymphoproliferative disease—A 20 years' experience from Austria

“…Several factors reportedly influence the prognosis of pediatric patients with PTLD. 13 , 36 , 60 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 Parameters associated with a poor prognosis are a history of malignant disease indicating transplantation, advanced disease, multifocal and extranodal disease, CNS, BM and graft involvement, female gender, B‐symptoms and elevated LDH levels at PTLD onset, high EBV load in PB at the time of diagnosis, CD20‐ and EBV‐negative as well as monomorphic and late‐onset PTLD. Considering the type of allograft, lung, liver, and hematopoietic stem cells were associated with poorer prognosis.…”

“…Several factors reportedly influence the prognosis of pediatric patients with PTLD. 13,36,60,[64][65][66][67][68][69][70][71][72][73] Parameters associated with a poor EFS or OS in our patient cohort, which may at least be partially owed to the relatively small number of patients included in our study.…”

Successful Treatment of Central Nervous System Post-Transplant Lymphoproliferative Disease With a Reduced Dose of High-Dose Methotrexate

“…The fifth edition of the World Health Organization's classification of hematolymphoid tumors introduced significant changes to the classification of immunodeficiency-associated lymphoproliferative disorders [ 5 ]. Previously, PTLD was classified into four major subtypes, which included early hyperplastic lesions, monomorphic, polymorphic, and classical Hodgkin lymphoma-like PTLD [ 6 ]. Most recent classifications focused on histologic and pathologic features as well as the causal association of specific lesions instead of grouping disorders based on the causative disease [ 5 ].…”

“…Treatment options for CNS lymphoma include the trial of immunosuppression reduction and the use of rituximab as monotherapy or in combination with other chemotherapy. Additionally, whole-brain radiation can be used [ 6 ].…”

18F-FDG PET/CT in the Diagnostic and Treatment Evaluation of Pediatric Posttransplant Lymphoproliferative Disorders

“…As reduction of immunosuppression is the first line intervention in many PTLD cases, prompt therapy particularly in non-destructive lesions, may be adequate to achieve remission. Nevertheless this therapy may also jeopardize the transplanted organ (10)(11)(12). Biopsy remains necessary for diagnostic confirmation, but imaging may be used to confirm/refute clinical suspicion of PTLD and identify suspicious lesions accessible for biopsy.…”