Open AccessTreatment of Epstein-Barr Virus Lymphoproliferative Disease after Hematopoietic Stem-Cell Transplantation with Hydroxyurea and Cytotoxic T-Cell Lymphocytes
Author(s) -
Samart Pakakasama,
Gretchen Eames,
Michael C. Morriss,
M. Helen Huls,
Cliona M. Rooney,
Helen E. Heslop,
Robert A. Krance
Publication year - 2004
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/01.tp.0000129813.54517.25
Subject(s) - medicine , hematopoietic stem cell transplantation , immunology , cytotoxic t cell , transplantation , rituximab , lymphoma , stem cell , epstein–barr virus , virus , biology , biochemistry , genetics , in vitro
Epstein-Barr virus (EBV) lymphoproliferative disease (LPD) is a potentially fatal complication that may follow allogeneic hematopoietic stem-cell transplantation (HSCT). In this article, the authors report a 2-year-old girl with Hurler's syndrome who developed multiple central nervous system (CNS) EBV LPD lesions 1 year after unrelated donor HSCT. Before this CNS occurrence, the patient had a complete response to rituximab treatment for EBV LPD of the spleen and lymph nodes; however, treatment of the CNS disease with rituximab proved ineffective. Because of reported favorable response of primary CNS EBV LPD in two human immunodeficiency virus-positive patients, the authors treated this patient with low-dose oral hydroxyurea. The patient improved clinically, with a decrease in size of multiple EBV LPD brain lesions. Subsequently, the patient received EBV-specific cytotoxic T-cell lymphocytes and remains well. The benefit and limited toxicity of hydroxyurea therapy merit its further consideration as treatment for EBV LPD.