[Adoptive transfer of Epstein-Barr virus-specific T-lymphocytes in chronic active Epstein-Barr infection].
METHODS
A 27-year-old man was admitted because of intermittent fever, fatigue, lymphadenopathy and splenomegaly for 20 years. Chronic administration of 6 - 8 g aspirin per day (self-prescribed) resulted in limited control of symptoms and in the development of analgesic nephropathy.


METHODS
The patient had prominent splenomegaly and lymphadenopathy without histological signs of malignancy. Monocytosis and T-lymphopenia were also present. Infectious disease testing revealed IgG+/IgM- EBV serology and EA-EBV-mRNA nested PCR clearly demonstrated the presence of lytic EBV-proteins in PBMCs.


METHODS
As chronic active Epstein-Barr virus infection (CAEBV) was highly probable, treatment with aciclovir, gancilovir and steroids was started. Because treatment failed adoptive T-cell transfer with autologous EBV-specific T-cells was performed. After three consecutive infusions the patient responded with a complete remission of fever, fatigue, lymphadenopathy and splenomegaly without adverse effects. Retrospective real-time PCR analysis showed a decrease in viral load from 62847 copies/ microg DNA to 45 - 250 copies after treatment. The patient remains in stable remission without signs of CAEBV (> 4 years).


CONCLUSIONS
Adoptive transfer of autologous, EBV-specific T-lymphocytes is a promising treatment in CAEBV.
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Institut für Medizinische Immunologie und Medizinischen Klinik m.S. Nephrologie und intern. Intensivmedizin, Charité, Humboldt-Universität. Berlin.
Hammer
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MH
Reinke
P
P
D000212:Acyclovir / Q000627:therapeutic use; D019264:Adoptive Transfer; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000235:genetics; D000998:Antiviral Agents / Q000627:therapeutic use; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000628:therapy*; D015774:Ganciclovir / Q000627:therapeutic use; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D012333:RNA, Messenger / Q000032:analysis; D013256:Steroids / Q000627:therapeutic use; D013601:T-Lymphocytes / Q000276:immunology*; D017211:Treatment Failure; D019562:Viral Load
D000914:Antibodies, Viral; D000956:Antigens, Viral; D000998:Antiviral Agents; C033305:Epstein-Barr virus early antigen; D012333:RNA, Messenger; D013256:Steroids; D015774:Ganciclovir; D000212:Acyclovir