Introduction

The term posttransplant lymphoproliferative disorder (PTLD) is used to describe a heterogeneous group of lymphoproliferative diseases that occur in hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients. These lymphoid disorders were first documented in the 1960s and were initially called "reticulum cell sarcomas."1 Interestingly, a subgroup of these diseases was labeled "pseudolymphomas" as these retained the ability to undergo spontaneous regression.2 We now have a greater understanding of PTLD, a disease that most often involves B cells and usually is associated with reactivation of latent Epstein-Barr virus (EBV) infections in the setting of decreased T-cell function. The incidence of this disorder is generally reported to range from 0.8 to 20%, but is felt to be underreported due to its varied clinical pre-sentation.3 4 These lymphomas are seen in different settings, and, some situations are much more likely to predispose to their occurrence than others. It is imperative that transplant physicians remain cognizant of this entity, as effective therapies are now available that can lower the mortality rate from the 50-80% range seen in the early 1990s5-8 to cure rates approaching 100% if patients are diagnosed when the tumor burden is low.9-10

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