Early identification of Epstein-Barr virus-associated post-transplantation lymphoproliferative disease.
Epstein-Barr virus-associated lymphoproliferative disease (EBV-LPD) is a common, usually fatal, complication developing after transplantation of bone marrow from HLA-mismatched or HLA-matched unrelated donors. Prompted by recent reports of successful treatment of EBV-LPD, we investigated methods which could result in early identification of patients at high risk for this disorder, thus improving the likelihood of successful therapeutic interventions. Both the outgrowth of transformed B lymphocytes ex vivo (100% correlation) and the detection of EBV DNA by a PCR method (80% correlation) showed statistically significant association with the histopathological diagnosis of EBV-LPD. Because these abnormalities can be detected prior to the onset of clinical disease. It should now be possible to use a combination of the methods described here to identify patients at high risk of developing EBV-LPD, thus enabling early therapeutic intervention.
Department of Virology and Molecular Biology, St Jude Children's Research Hospital, Memphis, TN 38105.
C M
CM
Rooney
S K
SK
Loftin
M S
MS
Holladay
M K
MK
Brenner
R A
RA
Krance
H E
HE
Heslop
D000293:Adolescent; D001402:B-Lymphocytes / Q000473:pathology; D015139:Blotting, Southern; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002455:Cell Division; D002472:Cell Transformation, Viral; D002478:Cells, Cultured; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006566:Herpesviridae Infections / Q000175:diagnosis*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007951:Leukemia, Myeloid / Q000628:therapy; D008232:Lymphoproliferative Disorders / Q000097:blood / Q000175:diagnosis* / Q000821:virology; D008297:Male; D013997:Time Factors; D014412:Tumor Virus Infections / Q000175:diagnosis*
D004279:DNA, Viral