Post-transplantation lymphoproliferative disorders in adults

POST-TRANSPLANTATION LYMPHOPROLIFERATIVE DISORDERS (PPTLDS) ARE defined as lymphomas that occur after transplantation (Fig. 1). Recipients of solid-organ or allogeneic hematopoietic stem-cell transplants have an increased risk of cancers related to immunosuppression and the Epstein-Barr virus (EBV) - in particular, lymphomas.1,2 Although lymphoproliferative disorders were initially reported to be a rare complication of transplantation, observations during the past decade have shown that they are not uncommon and are associated with poor outcomes. Lymphoma accounts for 21% of all cancers in recipients of solidorgan transplants, as compared with 4% among women and 5% among men in an immunocompetent population.3 Important advances in diagnosis and treatment have been made after two consensus conferences.4,5 This review outlines our current understanding of the epidemiology of and risk factors for PTLD, the pathogenesis of these disorders, and current approaches to diagnosis, staging, and treatment.