title: Failure to detect Epstein-Barr virus (EBV) DNA in plasma by real-time PCR in a case of EBV-associated posttransplantation lymphoproliferative disorder confined to the central nervous system.
abstract: We report here a patient who developed multiple central nervous system (CNS) space-occupying lesions 6 months after bone marrow transplantation from an HLA-matched unrelated donor. He had extensive chronic graft-versus-host disease and severe thrombocytopenia. Posttransplantation lymphoproliferative disorder (PTLD) was diagnosed after biopsy of the lesion was facilitated by the transfusion of 40 units of platelets. Epstein-Barr virus (EBV) DNA was not initially detected in the peripheral blood by real-time polymerase chain reaction, and the blood became positive for EBV at a low level only after more than 6 weeks had passed since the initial identification of detectable intracranial lesions. The patient died of cerebral herniation while donor leukocyte infusion was being prepared, and an autopsy confirmed the diagnosis of EBV-associated PTLD restricted to the CNS.
authors.affiliation: Department of Hematology and Clinical Research, Nagoya National Hospital, Japan.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Terasawa
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ohashi
authors.forename: Keitaro
authors.initials: K
authors.lastname: Tsushita
authors.forename: Makoto
authors.initials: M
authors.lastname: Utsumi
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Mukai
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nakamura
authors.forename: Masanori
authors.initials: M
authors.lastname: Shimoyama
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016543:Central Nervous System Neoplasms / Q000209:etiology / Q000473:pathology / Q000821:virology*; D004279:DNA, Viral / Q000097:blood*; D017809:Fatal Outcome; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000473:pathology / Q000821:virology*; D008297:Male; D016133:Polymerase Chain Reaction; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000276:immunology
chemical_list: D004279:DNA, Viral