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EBV Post-Transplant Lymphoproliferative Disorder

Diagnosis and treatment of PTLD in solid organ and stem cell transplant

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is EBV Post-Transplant Lymphoproliferative Disorder?

Post-transplant lymphoproliferative disorder (PTLD) is a heterogeneous spectrum of B-cell proliferations driven by uncontrolled Epstein-Barr virus replication in transplant recipients. WHO classifies PTLD into early lesions, polymorphic, monomorphic (DLBCL, Burkitt-like), and classic Hodgkin-like.

Risk is highest in EBV-seronegative recipients of EBV-positive donor organs, especially pediatric solid organ and intensively immunosuppressed transplants. EBV viral load monitoring by PCR allows preemptive intervention.

Treatment begins with reduction of immunosuppression, followed by rituximab monotherapy or rituximab plus chemotherapy (R-CHOP) for monomorphic disease. EBV-specific cytotoxic T-lymphocyte (CTL) therapy is effective for refractory disease. Surgery and radiation address localized lesions.

Symptoms

Lymphadenopathy
Fever and night sweats
Weight loss
Tonsillar hypertrophy
Allograft dysfunction or mass

Risk Factors

EBV donor-positive recipient-negative status
Pediatric transplantation
Intensive immunosuppression
T-cell depleting induction
Younger recipient age

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • For rising EBV viral load
  • For new lymphadenopathy in transplant patient
  • For B symptoms (fever, weight loss)
  • For allograft dysfunction with mass
  • For mononucleosis-like illness

Treatment Methods

01
Reduction of immunosuppression
02
Rituximab monotherapy
03
R-CHOP chemotherapy
04
EBV-specific cytotoxic T cells
05
Surgical resection of localized lesion
06
Radiation therapy for selected sites

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Enfeksiyon Hastalıkları Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.