National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Post-transplant lymphoproliferative disease


Other Names:
PTLD; Post-transplant lymphoproliferative disorder
Post-transplant lymphoproliferative disease (PTLD) is a complication of transplantation in which there is uncontrolled growth of lymphocytes.[1][2] It occurs in people whose immune systems have been intentionally suppressed due to having a solid organ transplant or hematopoietic stem cell transplant.[1] The severity of PTLD can range from causing a mild, noncancerous (benign) overgrowth of tissue, to causing a life-threatening, cancerous (malignant) form of lymphoma.[3] Common signs and symptoms are often vague, such as feeling unwell (malaise), fever, weight loss, night sweats, fatigue, and swollen lymph nodes.[2][3] Additional symptoms depend on the organs or body part(s) affected.[3] The digestive tract, central nervous system, and/or transplanted organ are often involved.[3]

PTLD is often caused by Epstein-Barr virus (EBV), which infects lymphocytes called B-cells. Most people get EBV in childhood, but the virus becomes "inactive" because the immune system keeps it under control. In people with PTLD due to EBV, a weakened immune system may allow EBV to reactivate in infected B-cells, leading to their uncontrolled growth. In some cases, EBV from the transplant donor is reactivated in the recipient. PTLD can also occur if a recipient first becomes infected with EBV after the transplant.[2][3] The reason that PTLD develops in people without EBV is not clear.[1]

PTLD is diagnosed by immunophenotyping a biopsy of an involved lymph node or other affected tissue.[2] Additional tests such as blood tests, imaging tests, or bone marrow biopsy may be needed to determine the location(s) and extent of the disease in the body.[2]

Treatment recommendations may vary among people with PTLD but typically include lowering the dose of immunosuppresive drugs to allow the immune system to fight the EBV-infected cells.[2] There are no therapies approved by the FDA to treat PTLD, but additional treatment options include using rituximab, surgery to remove affected tissue, radiation therapy, immunotherapy, and chemotherapy. Other treatments are being studied in clinical trials.[1][2]
Last updated: 2/5/2019

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Post-transplant lymphoproliferative disease. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Living with a genetic or rare disease can impact the daily lives of patients and families. These resources can help families navigate various aspects of living with a rare disease.

Financial Resources

  • Patient Access Network Foundation (PAN Foundation) has Assistance Programs for those with health insurance who reside in the United States. The disease fund status can change over time, so you may need to check back if funds are not currently available. 

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • The Leukemia and Lymphoma Society has an information page on Post-transplant lymphoproliferative disease. Click on the link to view this information page.
  • Lymphoma Action provides information about Post-transplant lymphoproliferative disease.
  • The National Kidney Foundation offers an information page on Post-transplant lymphoproliferative disease.
  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.

Selected Full-Text Journal Articles

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  1. Dierickx D, Habermann TM. Post-Transplantation Lymphoproliferative Disorders in Adults. N Engl J Med. February 8, 2018; 378(6):549-562. https://www.nejm.org/doi/full/10.1056/NEJMra1702693.
  2. Post-Transplant Lymphoproliferative Disorders. Leukemia & Lymphoma Society. July, 2018; https://www.lls.org/sites/default/files/National/USA/Pdf/Publications/FS33_PTLD_2018_FINAL.pdf.
  3. Post-Transplant Lymphoproliferative Disease. National Organization for Rare Disorders (NORD). 2018; https://rarediseases.org/rare-diseases/posttransplant-lymphoproliferative-disorders/.