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May 20, 2026Journal of Clinical Medicine0 citationsOpen Access

Global Epidemiology of Post-Transplant Lymphoproliferative Disorder (PTLD) in Hematopoietic Stem Cell Transplantation (HSCT): A Systematic Review and Meta-Analysis of Incidence, Subtypes, Risk Factors, and Beyond

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SKShahad Saif KhandkerAPAlif Hasan PrantoAJAfrin Rahman Juthy

Key Points

  • This study aims to quantify the global incidence of post-transplant lymphoproliferative disorder (PTLD) in hematopoietic stem cell transplantation (HSCT) and identify associated risk factors.
  • Conducted a systematic review and meta-analysis of 39 studies selected from 941 across three databases.
  • Calculated the pooled incidence rate and evaluated risk factors associated with PTLD in HSCT patients.
  • Quality assessment of included studies was performed to ensure reliability of findings.
  • Pooled incidence of PTLD was found to be 5.6% (95% CI: 5.0 to 6.3), rising to 12.4% (95% CI: 10.2 to 14.7) after excluding outliers.
  • PTLD occurrence was highest in allogenic HSCT at 5.6% (95% CI: 4.9 to 6.3) and reached 27.1% (95% CI: 21.4 to 32.8) in the European region.
  • Human leukocyte antigen (HLA) mismatch was identified as a significant risk factor in most studies.

Abstract

Background: Hematopoietic stem cell transplantation (HSCT) is a procedure used in different malignant and non-malignant diseases. Although post-transplant lymphoproliferative disorder (PTLD) is infrequently observed in patients with HSCT, no study on the overall global incidence rate is available to date. Methodology: In this study, we selected 39 studies from 941 studies from three databases (i.e., PubMed, ScienceDirect, and Google Scholar) to identify the global incidence rate of PTLD in HSCT. Results: The pooled incidence was determined to be 5.6% (95% CI: 5.0 to 6.3) and rose further to 12.4% (95% CI: 10.2 to 14.7) after excluding outlier studies. The quality of the studies was high as well. PTLD was prevalent the most in allogenic HSCT (i.e., 5.6% (95% CI: 4.9 to 6.3)) and within the European region (i.e., 27.1% (95% CI: 21.4 to 32.8)). Among risk factors, human leukocyte antigen (HLA) mismatch was reported in most of the studies. Conclusions: This study assessed and discussed the overall global incidence of PTLD in HSCT patients, continent-based incidence, and risk factors that can be helpful in finding the possible prevention mechanism of PTLD and implementing individualized treatment approaches based on the treatment availability during HSCT.

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Cite This Study

Khandker et al. (2026) studied this question.

synapsesocial.com/papers/6a0d4f34f03e14405aa9a6cehttps://doi.org/10.3390/jcm15103867
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