Posttransplantation B lymphoblastic leukemia with Burkitt-like features.
BACKGROUND
Posttransplantation Epstein-Barr virus-associated lymphoproliferative disease (PTLPD) occurs as a spectrum of disease ranging from benign, polyclonal, localized lymphoid hyperplasia to malignant, monoclonal, disseminated lymphoma, sometimes involving the bone marrow. To our knowledge, PTLPD has not been previously reported to present as acute lymphoblastic leukemia.


METHODS
We report the case of a boy who developed PTLPD in the form of acute lymphoblastic leukemia 6 years after cardiac transplantation. He had greater than 90% bone marrow invasion by Epstein-Barr virus-positive B lymphoblasts with Burkitt-like features and a t(8;14) translocation.


RESULTS
He was successfully treated with combination chemotherapy but unfortunately died, 6 months after completing treatment, from ischemic heart disease.


CONCLUSIONS
B lymphoblastic leukemia may occur as a manifestation of PTLPD and should be included in the classification of these diseases. Bone marrow examination should be an essential part of the investigation of patients suspected of having PTLPD.
Tweddle
D A
DA
Department of Child Health, Royal Victoria Infirmary, Newcastle, United Kingdom. D.A.Tweddle@newcastle.ac.uk
Gennery
A R
AR
Reid
M M
MM
Thomas
J A
JA
Burke
M
M
Hamilton
J R
JR
Windebank
K P
KP
D000284:Administration, Oral; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology / Q000821:virology; D002051:Burkitt Lymphoma / Q000209:etiology*; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000097:blood; D020031:Epstein-Barr Virus Infections / Q000097:blood; D006084:Graft Rejection / Q000188:drug therapy; D016027:Heart Transplantation / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use
D011239:Prednisolone