Post Transplant Lymphoproliferative Disorder (PTLD) is a lymphoid proliferation arising in a recipient of a solid organ transplant, allogeneic bone marrow transplantation, or an umbilical cord blood transfusion. The patient must  have a history of a solid organ transplant or an allogeneic bone marrow transplant. Both polymorphic and monomorphic PTLD are actually caused by post-transplant immunosuppression. Most cases of PTLD occur within a year of transplantation; however, they can occur any time after the transplant. Monomorphic PTLD may have histology indistinguishable from that of various malignant hematopoietic neoplasms, particularly lymphomas such as Diffuse Large B-cell Lymphoma.

The presence of PTLD, either polymorphic or monomorphic, has clinical significance and prognostic value, especially in the Pediatric and Adolescence and Young Adult (AYA) populations.

Note 1: Post Transplant Lymphoproliferative Disorder (PTLD) is a lymphoid proliferation arising in a recipient of a solid organ transplant, allogeneic bone marrow transplantation, or an umbilical cord blood transfusion. The development of PTLD is clinically significant and a prognostic indicator.

• Code 0 if the patient has NO or UNKNOWN history of a solid organ transplant, allogeneic bone marrow transplantation, or an umbilical cord blood transplant AND there is no mention of PTLD in the pathology report

Note 2: There are several types of PTLD

• Polymorphic PTLD: This is a PTLD by itself, there is no histology that is identical to that of another other type of Hematopoietic neoplasm. This type of PTLD is NOT collected in this data item.
• Monomorphic PTLD (Code 2): This is the most common PTLD and may have a histology identical to that of another malignant hematopoietic neoplasm. Most common, but not limited to, diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma 
• Classic Hodgkin lymphoma-PTLD type (Code 3): Under the microscope, Reed-Sternberg cells, which are associated with Hodgkin lymphoma are present
• PTLD, NOS (Code 4): Used when only PTLD (NOS) is documented and there is no mention of monomorphic or Hodgkin like type

Note 3: This SSDI is effective for diagnosis years 2025+. 

• For cases diagnosed prior to 2025, leave this SSDI blank.