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

Background: Hematopoietic stem cell transplantation (HSCT) is a popular subtype of transplantation used in different malignant and non-malignant diseases, especially when treatment or therapeutics do not work. Although post-transplantation lymphoproliferative disease (PTLD) is often observed in patients with HSCT, no study on the overall global prevalence 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 prevalence rate of PTLD in HSCT. Result: The pooled prevalence was determined as 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. The prevalence of death cases among the HSCT was determined as 0.6% (95%CI: 0.4 to 0.9). 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%I: 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.