Guidelines on Diagnosis and Treatment of Malignant Lymphomas

Post-Transplant
Lymphoproliferative Disease
Definition and Incidence
A spectrum of lymphoproliferative disease (PTLD) is described in
transplant recipients, including post-transplant infectious
mononucleosis, benign polyclonal polymorphic B-cell hyperplasia,
and monoclonal polymorphic lymphoma. Most are EBV-related.
ICD – 0 Code:
9970 / 1 (Polymorphic PTLD)
Management
Patients with post-transplant infectious mononucleosis or
benign polyclonal polymorphic B-cell hyperplasia may be
treated with antiviral drugs such as acyclovir. Patients with
overt lymphoma should be treated with withdrawal of
immunosuppression to levels consistent with graft survival,
and appropriate intensive Rituximab containing chemotherapy
such as R-CHOP. Close attention is required for prevention
and management of opportunistic infections in these high-risk
patients. Patients should be managed in a centre where a
multidisciplinary team with expertise in both NHL and
management of transplant patients is available
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