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Epstein‐Barr virus (EBV)‐associated post‐transplantation lymphoproliferative disorder simultaneously affecting both B and T cells after allogeneic bone marrow transplantation
Author(s) -
Chuhjo Tatsuya,
Yachie Akihiro,
Kanegane Hirokazu,
Kimura Hiroshi,
Shiobara Shintaro,
Nakao Shinji
Publication year - 2003
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.10303
Subject(s) - epstein–barr virus , cd20 , lymphoproliferative disorders , cd8 , aplastic anemia , transplantation , immunology , bone marrow , biology , b cell , virology , virus , pathology , medicine , lymphoma , antigen , antibody
Post‐transplantation lymphoproliferative disorder (PTLD) is usually an aberrant proliferation of EBV‐infected B cells. We report the case of a 31‐year‐old man with severe aplastic anemia who suffered PTLD 42 days post‐BMT from an unrelated donor. At the onset of PTLD, peripheral blood lymphocytes were comprised of 40% CD20 + cells, 3% CD4 + cells, and 56% CD8 + cells. A highly sensitive in situ hybridization (ISH) method was used to detect EBV‐encoded small non‐polyadenylated RNA 1 (EBER‐1) in 33.9% of sorted CD20 + cells, 4.4% of CD4 + cells, and 1.4% of CD8 + cells. Each T‐cell fraction contained less than 0.034% of contaminated EBV‐infected B cells. Clonal proliferation of both B and T cells was demonstrated by Southern blotting. The patient did not respond to donor leukocyte infusion and died due to deterioration of PTLD. At autopsy, examination of multiple organs revealed B‐cell (rather than T‐cell) infiltration. This case clearly indicates that EBV can simultaneously infect B and T cells and can induce clonal proliferation of both lymphocyte subsets in severely immunocompromised patients. Am. J. Hematol. 72:255–258, 2003. © 2003 Wiley‐Liss, Inc.