eMedicine Specialties > Pediatrics: General Medicine > Oncology

Lymphoproliferative Disorders: Follow-up

Author: Stuart S Winter, MD, Associate Professor, Department of Pediatrics, University of New Mexico Health Sciences Center
Contributor Information and Disclosures

Updated: Nov 24, 2009

Follow-up

Further Inpatient Care

  • Follow-up care of a child with lymphoproliferative disorder (LPD) can range from simple (eg, watchful observation) to very complex (bone marrow transplantation).
  • Coordinate with a team of subspecialists familiar with immunodeficiency disorders and the management of potentially toxic drug therapy.

Inpatient & Outpatient Medications

  • Inpatient and outpatient drugs depend on the nature of the underlying immunodeficiency syndrome.

Deterrence/Prevention

  • The best preventive measure is to correct the underlying immunodeficiency syndrome.
  • Children who have had a bone marrow transplant with an immunocompetent graft are unlikely to develop problems with a lymphoproliferative disorder.

Prognosis

  • Lymphoproliferative disorders prognoses are determined by the prevalence of immunodeficiency in the patient.
  • Ordinarily, a favorable response in a relatively immunocompetent patient augurs well for long-term survival. Lymphoproliferative disorders of low-grade histological features tend to remit with a reduction of immunosuppression, whereas higher-grade lymphoproliferative disorders require a more aggressive therapeutic approach and often require several cycles of CHOP therapy with close follow-up.

Miscellaneous

Medicolegal Pitfalls

  • Treatment of lymphoproliferative disorders (LPDs) in immunocompromised hosts is best left to healthcare personnel who are accustomed to treating the diseases and drug toxicities associated with chemotherapeutic agents or immune suppressants and who are able to ensure adequate follow-up care.
  • For instance, the long-term follow-up of affected patients is coordinated by a transplant program where the needs of a patient with a lymphoproliferative disorder can be balanced against graft/organ rejection.
 


More on Lymphoproliferative Disorders

Overview: Lymphoproliferative Disorders
Differential Diagnoses & Workup: Lymphoproliferative Disorders
Treatment & Medication: Lymphoproliferative Disorders
Follow-up: Lymphoproliferative Disorders
Multimedia: Lymphoproliferative Disorders
References
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Further Reading

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Keywords

lymphoproliferative disorders, LPD, immune dysfunction in children, immune deficiency disorders, immune disorder, X-linked immunodeficiency, agammaglobulinemia, autoimmune lymphoproliferative syndrome, severe combined immunodeficiency, common variable immunodeficiency

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Contributor Information and Disclosures

Author

Stuart S Winter, MD, Associate Professor, Department of Pediatrics, University of New Mexico Health Sciences Center
Stuart S Winter, MD is a member of the following medical societies: American Association for Cancer Research, American Society of Pediatric Hematology/Oncology, Children's Oncology Group, New Mexico Pediatric Society, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Medical Editor

Kathleen M Sakamoto, MD, PhD, Professor and Chief, Division of Hematology-Oncology, Vice-Chair of Research, Mattel Children's Hospital at UCLA; Co-Associate Program Director of the Signal Transduction Program Area, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA and California Nanosystems Institute and Molecular Biology Institute, UCLA
Kathleen M Sakamoto, MD, PhD is a member of the following medical societies: American Society of Hematology, American Society of Pediatric Hematology/Oncology, International Society for Experimental Hematology, Society for Pediatric Research, and Western Society for Pediatric Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Timothy P Cripe, MD, PhD, Professor of Pediatric Hematology/Oncology, University of Cincinnati; Director, Translational Research Trials Office, Department of Pediatrics, Cincinnati Children's Hospital Medical Center
Timothy P Cripe, MD, PhD is a member of the following medical societies: American Association for the Advancement of Science, American Pediatric Society, American Society of Hematology, American Society of Pediatric Hematology/Oncology, and Society for Pediatric Research
Disclosure: Nothing to disclose.

CME Editor

Samuel Gross, MD, Professor Emeritus, Department of Pediatrics, University of Florida; Clinical Professor, Department of Pediatrics, University of North Carolina; Adjunct Professor, Department of Pediatrics, Duke University
Samuel Gross, MD is a member of the following medical societies: American Association for Cancer Research, American Society for Blood and Marrow Transplantation, American Society of Clinical Oncology, American Society of Hematology, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Chief Editor

Robert J Arceci, MD, PhD, King Fahd Professor of Pediatric Oncology, Professor of Pediatrics, Oncology and the Cellular and Molecular Medicine Graduate Program, Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine
Robert J Arceci, MD, PhD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Pediatric Society, American Society of Hematology, and American Society of Pediatric Hematology/Oncology
Disclosure: Nothing to disclose.

 
 
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