Post-transplant lymphoproliferative disease: association with induction therapy?

In the last 2 decades, several polyclonal and monoclonal antibodies have been developed for induction therapy in the early post solid-organ transplantation period. The use of these antibodies has been associated, for the most part, with a decrease in early acute rejection rates. However, there has been a simultaneous rise in infectious complications, particularly in the incidence of post-transplant lymphoproliferative disease (PTLD). Determinations of adjusted odds ratios or relative risk have yielded conflicting information regarding whether these antibody agents increase the risk for PTLD. In order to interpret the results of the different studies, the reader requires a detailed knowledge of the types of analyses performed and the characteristics of the populations studied. This article analyses the available data on PTLD risk after the use of induction antibody agents. While some studies suggest an increased risk of PTLD after induction antibody use, other studies do not; the available data are not conclusive either way at this time.