Radiotherapy is the best treatment method in post transplant lymphoproliferative disorders localizing in brain: a review of the literature.

BACKGROUND: Localization of post transplant lymphoproliferative disorders (PTLD) in the central nervous system (CNS) is a rare but life-threatening complication of transplantation. In the current study, we sought to aggregate data of PTLD in the series existing in the literatures on brain localization of PTLD and to concentrate on the management methods of the disease to compare and find the best treatment strategies in these patients.

MATERIAL/METHODS: We conducted a thorough search of the literature to find treatment strategies employed to manage CNS involvement by PTLD. Data were pooled and standardized and reanalyzed.

RESULTS: Overall 79 patients with CNS PTLD were entered into analysis. Patients undergone radiotherapy represented a significant superior outcome compared to that of patients who had not received radiotherapy (p<0.05). other treatment strategies had no significant impact on the survival (p>0.2 for all). One and five years survival rates for CNS involved PTLD patients who underwent radiotherapy were 71% and 37%, respectively; compared to 41% and 28%, respectively, for the control group.

CONCLUSIONS: In the current study, we found that radiotherapy is an effective method of treatment for organ recipients who develop PTLD within central nervous system during their post transplant period. No beneficial effect for chemotherapy, interferon alfa, or a combination of them with radiotherapy was detected. We recommend using radiotherapy in all transplant patients developing CNS PTLD.