Abstract
A 16-year-old boy in complete remission of ALL, undergoing oral maintenance therapy, developed intestinal perforation related to EBV-associated lymphoproliferative disease (LPD). He was successfully managed with surgical resection, acyclovir, immunoglobulins and discontinuation of maintenance therapy. Leukemic marrow relapse occurred 3 months later, treated by polychemotherapy followed by unmanipulated BMT from a matched unrelated EBV seropositive donor. Donor lymphocytes were infused twice after transplant because of delayed immunologic recovery and severe CMV colitis. This was followed by acute GVHD requiring prolonged immunosuppressive treatment. Despite intensive and prolonged immunosuppression, recurrence of LPD was not observed. Following EBV-related LPD, allogeneic BMT can be performed if indicated. Selection of an EBV seropositive donor is of major importance for the prevention of LPD recurrence as the recipient may be protected by passive transfer of EBV-specific cytotoxic T cells. Bone Marrow Transplantation (2001) 27, 93–95.
Similar content being viewed by others
References
Rohrlich P, Lescoeur B, Rahimy C, Vilmer E . Epstein–Barr virus associated B cell lymphoproliferation in an infant treated for acute lymphoblastic leukemia Blood 1993 81: 264 (letter)
Mustafa MM, Winick NJ, Margraf LR . Epstein–Barr virus lymphoproliferative disorder in children with leukemia: case report and review of the literature J Pediatr Hematol Oncol 1997 19: 77–81
Foran JM, Slater SE, Norton AJ et al. Monoclonal Epstein–Barr virus-related lymphoproliferative disorder following adult acute lymphoblastic leukaemia Br J Haematol 1999 106: 713–716
O'Meara A, Headon B, Reen DJ . Effect of methotrexate on the immune response in children with acute lymphatic leukaemia Immunopharmacology 1985 9: 33–38
Swinnen LJ, Mullen GM, Carr TJ et al. Aggressive treatment for postcardiac transplant lymphoproliferation Blood 1995 86: 3333–3340
Benkerrou M, Jais JP, Leblond V et al. Anti-B cell monoclonal antibody treatment of severe post-transplant B-lymphoproliferative disorder: prognostic factors and long-term outcome Blood 1998 92: 3137–3147
Milpied N, Vasseur B, Parquet N et al. Humanized anti-CD20 monoclonal antibody (Rituximab) in post transplant B-lymphoproliferative disorder: a retrospective analysis on 32 patients Ann Oncol 2000 11: (Suppl. 1) 113–116
Liebowitz D, Anastasi J, Hagos F et al. Post-transplant lymphoproliferative disorders (PTLD): clinicopathologic characterization and response to immunomodulatory therapy with interferon-α Ann Oncol 1996 7: 28 (Abstr.)
Papadopoulos EB, Ladanyi M, Emanuel D et al. Infusions of donor leukocytes to treat Epstein–Barr virus-associated lymphoproliferative disorders after allogeneic bone marrow transplantation New Engl J Med 1994 330: 1185–1191
Rooney CM, Smith CA, Ng CY et al. Use of gene-modified virus-specific T lymphocytes to control Epstein–Barr virus-related lymphoproliferation Lancet 1995 345: 9–13
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pondarré, C., Kebaili, K., Dijoud, F. et al. Epstein–Barr virus-related lymphoproliferative disease complicating childhood acute lymphoblastic leukemia: no recurrence after unrelated donor bone marrow transplantation. Bone Marrow Transplant 27, 93–95 (2001). https://doi.org/10.1038/sj.bmt.1702727
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1702727
- Springer Nature Limited