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PTLD Webinar

PTLD: What's That About

April 30, 2019 | 1 pm Central Time


Post-transplant lymphoproliferative disease (PTLD) is a major complication of solid organ transplantation. PTLD occurs in 2–15% of pediatric solid organ transplant (SOT) patients, depending on the organ transplanted and the immunosuppression used (Llaurador, 2017). The incidence of transplantation in pediatrics is steadily rising making PTLD the most common form of lymphoproliferation in childhood (Llaurador, 2017). Features of PTLD are similar to an immune system malignancy with abnormal proliferation of lymphoid lineage cells, typically B cells, in the setting of immunosuppression and often associated with EBV infection (Dharnidharka, 2017). Presentation and treatment choice covers a wide spectrum. The goal is to preserve the transplanted organ/graft while eradicating the lymphoproliferative disease. Most often the first intervention is reduction of immunosuppression (Dharnidharka, 2017) and is generally managed by the transplant team. Oncology providers become a prominent member of the multidisciplinary team for patients with more aggressive or disseminated disease. Treatment options include monoclonal antibody alone or addition of chemotherapeutic agents. Response rates of 50% have been reported with use of single agent rituximab and EFS rates of around 70% with combination low dose chemotherapy and rituximab (Llaurador, 2017). New treatment strategies are being tested to improve these response rates. With rising incidence of pediatric transplantation, it is critical that the oncology nurse be aware of this diagnosis and treatment options to provide optimal care and education to the patient and family. This lecture will review PTLD following solid organ transplantation including risk factors, pathophysiology, clinical presentation/diagnostic workup, and treatment options. Case studies will be presented to help nurses gain a clear understanding of this disorder and treatment options so as to provide optimal care and education to the patient and family.



Joan Ronan, MSN CPNP CPON®
Boston Children’s Hospital
Boston, MA

Anna Lefebvre, MSN CPNP CPON®
Boston Children’s Hospital
Boston, MA

Kathleen Stiffler, MSN NP CPNP
Boston Children’s Hospital
Boston, MA

Accreditation and Disclaimers

Accreditation Statement

The Association of Pediatric Hematology/Oncology Nurses (APHON) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning Outcomes

Learning Outcome 1: The learner will be able to describe PTLD presentation, staging and treatment options.

Learning Outcome 2: The learner will be able to understand the importance of effective collaboration between multiple care teams.

The measurement of these outcomes will be evidenced by evaluations and post testing.

ONCC Individual Learning Needs Assessment (ILNA) Statement and Disclaimer

The program content has been reviewed by the Oncology Nursing Certification Corporation (ONCC) and is acceptable for recertification points.

1 ILNA Point in Early-Post Transplant Management OR Late-Post Management Transplant OR Treatment OR Symptom Management.

ONCC review is only for designating content to be used for recertification points and is not for CNE accreditation. CNE programs must be formally approved for contact hours by an acceptable accreditor/approver of nursing CE to be used for recertification by ONCC. If the CNE provider fails to obtain formal approval to award contact hours by an acceptable accrediting/approval body, no information related to ONCC recertification may be used in relation to the program. Have questions regarding the CPHON® ILNA Coding? Please visit the ONCC website or call them toll-free at 877.769.ONCC (US and Canada only).

The webinar content applies to multiple content areas across multiple credentials. Individual nurse’s learning plans are linked to the ONCC Test Blueprint for the certification they hold. Review the current test blueprint available on the ONCC website to determine where the content fits.

Faculty Disclosure of Relevant Financial Relationship(s)

Faculty and nurse planners have reported no conflict of interest with the content of this activity.