Treatment. The overall approach to treatment of PTLD will vary according to the individual risk, clinical presentation, and stage and sites of disease. In general, treatment starts with reduction of immunosuppression, antiviral therapy if early in the pathogenesis, anti-CD20 therapy (monoclonal B cell inhibitor), and chemotherapy with CHOP (ie, cyclophosphamide, hydroxydaunorubicin, vincristine [Oncovin], prednisone) for more widely disseminated disease. Immunosuppression is reduced specifically by elimination of the cell cycle inhibitor/antimetabolite, decreasing calcineurin inhibition, and lowering corticosteroid dosing.