The IPTA Nashville consensus conference on post-transplant lymphoproliferative disorders after solid organ transplantation in children: IV-consensus guidelines for the management of post-transplant lymphoproliferative disorders in children and adolescents

Allen, Upton D. L'Huillier, Arnaud G. Bollard, Catherine M. Gross, Thomas G. Hayashi, Robert J. Höcker, Britta Maecker‐Kolhoff, Britta Marks, Stephen D. Mazariegos, George Vincent Smets, Françoise [UCL] Trappe, Ralf U. Visner, Gary Chinnock, Richard E. Comoli, Patrizia Danziger‐Isakov, Lara Dulek, Daniel E. Dipchand, Anne I. Ferry, Judith A. Martinez, Olivia M. Metes, Diana M. Michaels, Marian G. Preiksaitis, Jutta Squires, James E. Swerdlow, Steven H. Wilkinson, James D. Dharnidharka, Vikas R. Green, Michael Webber, Steven A. Esquivel, Carlos O. et al.[show all]

The International Pediatric Transplant Association convened an expert consensusconference to assess current evidence and develop recommendations for various as-pects of care relating to post-transplant lymphoproliferative disorders (PTLD) afterpediatric solid organ transplantation. This report addresses the outcomes of delib-erations by the PTLD Management Working Group. A strong recommendation wasmade for reduction in immunosuppression as the first step in management. Similarly,strong recommendations were made for the use of the anti-CD20 monoclonal anti-body (rituximab) as was the case for chemotherapy in selected scenarios. In some sce-narios, there is uncoupling of the strength of the recommendations from the availableevidence in situations where such evidence is lacking but collective clinical experi-ences drive decision-making. Of note, there are no large, randomized phase III trials ofany treatment for PTLD in the pediatric age group. Current gaps and future researchpriorities are highlighted.