Reiche W, Tauseef A, Sabri A, Mirza M, Cantu D, Silberstein P, Chandan S. Gastrointestinal manifestations, risk factors, and management in patients with post-transplant lymphoproliferative disorder: A systematic review. World J Transplant 2022; 12(8): 268-280 [PMID: 36159076 DOI: 10.5500/wjt.v12.i8.268]
Corresponding Author of This Article
William Reiche, DO, Doctor, Department of Medicine, CHI Creighton University Medical Center, 7500 Mercy Road, Omaha, NE 68124, United States. reichewilliam@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Aug 18, 2022; 12(8): 268-280 Published online Aug 18, 2022. doi: 10.5500/wjt.v12.i8.268
Gastrointestinal manifestations, risk factors, and management in patients with post-transplant lymphoproliferative disorder: A systematic review
William Reiche, Abubakar Tauseef, Ahmed Sabri, Mohsin Mirza, David Cantu, Peter Silberstein, Saurabh Chandan
William Reiche, Abubakar Tauseef, Mohsin Mirza, Department of Medicine, CHI Creighton University Medical Center, Omaha, NE 68124, United States
Ahmed Sabri, David Cantu, Department of Pathology, CHI Creighton University Medical Center, Omaha, NE 68124, United States
Peter Silberstein, Division of Hematology and Oncology, Department of Medicine, CHI Creighton University Medical Center, Omaha, NE 68124, United States
Saurabh Chandan, Division of Gastroenterology and Hepatology, Department of Medicine, CHI Creighton University Medical Center, Omaha, NE 68124, United States
Author contributions: Reiche W, Tauseef A, and Sabri A involved in data acquisition; Reiche W drafted the article, final approval; Tauseef A contributed to the data acquisition; Sabri A involved in pathology figures, drafting the article; Mirza M, Cantu D, Silberstein P, Chandan S involved in critical revision, final approval.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: William Reiche, DO, Doctor, Department of Medicine, CHI Creighton University Medical Center, 7500 Mercy Road, Omaha, NE 68124, United States. reichewilliam@gmail.com
Received: January 7, 2022 Peer-review started: January 7, 2022 First decision: March 9, 2022 Revised: March 24, 2022 Accepted: August 5, 2022 Article in press: August 5, 2022 Published online: August 18, 2022 Processing time: 223 Days and 0.9 Hours
Abstract
BACKGROUND
Patients with a history of solid organ transplantation (SOT) or hematopoietic stem cell transplantation (HSCT) are at an increased risk of developing post-transplant lymphoproliferative disorder (PTLD). The gastrointestinal (GI) tract is commonly affected as it has an abundance of B and T cells.
AIM
To determine typical GI-manifestations, risk factors for developing PTLD, and management.
METHODS
Major databases were searched until November 2021.
RESULTS
Non-case report studies that described GI manifestations of PTLD, risk factors for developing PTLD, and management of PTLD were included. Nine articles written within the last 20 years were included in the review. All articles found that patients with a history of SOT, regardless of transplanted organ, have a propensity to develop GI-PTLD.
CONCLUSION
GI tract manifestations may be nonspecific; therefore, consideration of risk factors is crucial for identifying GI-PTLD. Like other lymphoma variants, PTLD is very aggressive making early diagnosis key to prognosis. Initial treatment is reduction of immunosuppression which is effective in more than 50% of cases; however, additional therapy including rituximab, chemotherapy, and surgery may also be required.
Core Tip: Patients with a history of solid-organ or hematopoietic stem cell transplantation are at an increased risk of developing post-transplant lymphoproliferative disorder (PTLD). The gastrointestinal (GI) tract is commonly affected as it has an abundance of B and T-cells. GI tract manifestations may be nonspecific; therefore, consideration of risk factors is crucial for identifying GI-PTLD. Like other lymphoma variants, PTLD is very aggressive making early diagnosis key to prognosis. Initial treatment is reduction of immunosuppression which is effective in more than 50% of cases; however, additional therapy including surgery and chemotherapy may also be required. We performed a systematic review of GI-PTLD to better describe GI manifestations, risk factors for disease, and management of GI-PTLD.
