title: Fatal outcome in a patient developing Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD) without measurable disease.
abstract: A 51-year-old female patient in the first chronic phase of CML received an allogeneic PBSCT from a matched unrelated donor. The transplant was manipulated by CD34+ cell selection. On day +193 after transplantation the patient was readmitted to the hospital with recurrent fever of unknown origin and cough. Clinical, radiographic and sonographic evaluation revealed no characteristic findings besides a mild splenomegaly. Screening for EBV, CMV, RSV and HSV did not indicate an active infection. On day +203 the patient developed generalized seizures, respiratory failure and died within 24 h in multiorgan failure. The macroscopic postmortem was still not enlightening; the histological examination however, demonstrated diffuse organ infiltration by monoclonal lymphoblastoid cells due to EBV-LPD.
authors.affiliation: Department of Internal Medicine III, University Hospital of Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Ringhoffer
authors.forename: K
authors.initials: K
authors.lastname: Döhner
authors.forename: S
authors.initials: S
authors.lastname: Scheil
authors.forename: H
authors.initials: H
authors.lastname: Wilts
authors.forename: T
authors.initials: T
authors.lastname: Mertens
authors.forename: W
authors.initials: W
authors.lastname: Grimminger
authors.forename: H
authors.initials: H
authors.lastname: Döhner
authors.forename: D
authors.initials: D
authors.lastname: Bunjes
mesh_terms: D017809:Fatal Outcome; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D004854:Herpesvirus 4, Human; D006801:Humans; D007150:Immunohistochemistry; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000628:therapy; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000209:etiology / Q000821:virology*; D008875:Middle Aged; D014184:Transplantation, Homologous