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How we diagnose and treat posttransplant lymphoproliferative disorders.
Blood. 2015 Sep 17;
Authors: Dierickx D, Tousseyn T, Gheysens O
Abstract
Posttransplant lymphoproliferative disorder (PTLD) is a potentially fatal disorder arising after solid organ or hematopoietic stem cell transplantation. Iatrogenically impaired immune surveillance and Epstein-Barr virus (EBV) primary infection or reactivation are key factors in the pathogenesis. However current knowledge on all aspects of PTLD is limited due to its rarity, morphological heterogeneity and the lack of prospective trials. Furthermore, the broad spectrum of underlying immune disorders and the type of graft represent important confounding factors. Despite these limitations several reviews have been written aimed at offering a guide for pathologists and clinicians in diagnosing and treating PTLD. Rather than providing another classical review on PTLD, this 'How I diagnose and treat PTLD' article will -based on two case reports- focus on some specific challenges, novel insights and perspectives in pathogenesis, diagnosis and treatment of PTLD. These challenges include the wide variety of PTLD presentation making treatment optimization difficult, the impact of EBV on pathogenesis and clinical behavior and the controversial treatment of Burkitt lymphoma-PTLD.
PMID: 26384356 [PubMed - as supplied by publisher]