Global Prevalence of Post-Transplantation Lymphoproliferative Disease (PTLD) in Hematopoietic Stem Cell Transplantation (HSCT): A Systematic Review and Meta-Analysis

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Abstract
Background: Hematopoietic stem cell transplantation (HSCT) is a widely utilized subtype of transplantation employed in various malignant and non-malignant diseases, particularly when conventional treatments or therapeutics prove ineffective. Despite the frequent occurrence of post-transplantation lymphoproliferative disease (PTLD) in patients undergoing HSCT, no comprehensive global prevalence rate has been established 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 prevalence rate of PTLD in HSCT patients. Results: The pooled prevalence was determined as 5.6% (95% CI: 5.0 to 6.3) and increased to 12.4% (95% CI: 10.2 to 14.7) after excluding outlier studies. The quality of the studies was also high. The prevalence of death cases among HSCT patients was determined as 0.6% (95% CI: 0.4 to 0.9). PTLD was most prevalent 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, HLA mismatch was reported in most of the studies. Conclusion: This study assessed and discussed the overall global prevalence of PTLD in HSCT patients, continent-based prevalence, 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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