Post-Transplant Lymphoproliferative Disease (Pediatric)

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Post-transplant lymphoproliferative disease

Post-transplant lymphoproliferative disease (PTLD) is an uncommon condition occurring in people who have been given immunosuppressive therapy (medicine that limits the activity of the immune system) after receiving an organ transplant. PTLD is a cancerous condition in which the body produces too many cells in the lymphoid system, which is part of the immune system. In most, but not all cases of PTLD, the patient also has been exposed to Epstein-Barr virus.

The possible symptoms of PTLD can vary from patient to patient, which means it can take a long time in some cases to detect the existence of PTLD tumors. Common symptoms include fever, gastrointestinal symptoms, infectious mononucleosis (also known as “mono”), and difficulty breathing. However, once a patient has received an organ transplant, the health care provider knows to monitor regularly for the occurrence of PTLD.

Our approach to post-transplant lymphoproliferative disease

PTLD requires a medical team with expertise across several fields, including transplantation, immunology, oncology, and virology. Diagnosing PTLD includes imaging with ultrasound, CT scans, or MRI, depending on the part of the body being examined for cancer cells. Patients will also be tested to see if they have been exposed to the Epstein-Barr Virus.

Patients with PTLD are at high risk for illness or even loss of the transplanted organ, so early, aggressive treatment is important. Treatment options for PTLD include the following: reduction of immunosuppressive medications, treatment with a targeted medication called rituximab, a course of antiviral drugs, and chemotherapy, in which medicines are used to attack the abnormal cells.