Post transplant lymphoproliferative disorder: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 42: Line 42:
[[Post transplant lymphoproliferative disorder case study one|Case #1]]
[[Post transplant lymphoproliferative disorder case study one|Case #1]]


==Overview==
Post-transplant lymphoproliferative disorder (PTLD) is the name given to a group of [[B cell]] [[lymphoma|lymphomas]] occurring in [[Immunosuppression|immunosuppressed]] patients following [[organ transplant]].


==Incidence and prevalence==
==Incidence and prevalence==

Revision as of 14:49, 21 September 2012

Post transplant lymphoproliferative disorder
ICD-O: M9970/1
DiseasesDB 34154

Post transplant lymphoproliferative disorder Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Post transplant lymphoproliferative disorder from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Post transplant lymphoproliferative disorder On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Post transplant lymphoproliferative disorder

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Post transplant lymphoproliferative disorder

CDC on Post transplant lymphoproliferative disorder

Post transplant lymphoproliferative disorder in the news

Blogs on Post transplant lymphoproliferative disorder

Directions to Hospitals Treating Post transplant lymphoproliferative disorder

Risk calculators and risk factors for Post transplant lymphoproliferative disorder

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and Keywords: PTLD

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Post transplant lymphoproliferative disorder from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1


Incidence and prevalence

It is an uncommon condition occurring in 0.2% of patients within one year of transplant, with an annual incidence of 0.04% thereafter. The risk of developing the disease is higher in children and recipients of heart transplants.

Causes

The disease is an uncontrolled proliferation of B cell lymphocytes following infection with Epstein-Barr virus. Production of an interleukin-10, an endogenous anti-T cell cytokine, has also been implicated.

In immunocompetent patients, Epstein-Barr virus causes infectious mononucleosis, characterised by a proliferation of B-lymphocytes which is controlled by Suppressor T cells.

However, calcineurin inhibitors (tacrolimus and cyclosporine) used as immunosuppressants in organ transplantation inhibit T cell function, and can prevent the control of the B cell proliferation.

Depletion of T cells by use of anti-T cell antibodies in the prevention or treatment of transplant rejection further increases the risk of developing post-transplant lymphoproliferative disorder. Such antibodies include ATG, ALG and OKT3.

Polyclonal PTLD may form tumor masses and present with symptoms due to a mass effect, e.g. symptoms of bowel obstruction. Monoclonal forms of PTLD tend to form a disseminated malignant lymphoma.

Treatment

PTLD may spontaneously regress on reduction or cessation of immunosuppressant medication, and can also be treated with addition of anti-viral therapy. In some cases it will progress to non-Hodgkin's lymphoma and may be fatal.

Resources

Related chapters

References

Template:Organ transplantation


Template:WikiDoc Sources