Successful control of Epstein-Barr virus (EBV)-infected cells by allogeneic nonmyeloablative stem cell transplantation in a patient with the lethal form of chronic active EBV infection.
Chronic active Epstein-Barr virus infection (CAEBV) is a heterogeneous EBV-related disorder, ranging from mild/moderate forms to rapidly lethal disorders. The lethal form of CAEBV is characterized by multiple organ failure, hemophagocytic syndrome, and development of lymphomas. Allogeneic stem cell transplantation is considered as the only potentially curative treatment for the lethal form of CAEBV, but it is not always desirable because of the high incidence of regimen-related toxicities. A 17-year-old female with CAEBV, who was refractory to conventional therapies and considered to be unable to receive a myeloablative regimen because of multiple organ dysfunction, underwent allogeneic nonmyeloablative stem cell transplantation (allo-NST) before developing a hematological malignancy. She has been well without any signs of CAEBV for 27 months after allo-NST, and we confirmed that specific cytotoxic T lymphocyte activity against EBV was reconstituted. This outcome suggests that allo-NST can control CAEBV by reconstituting the host immunity against EBV.
Uehara
Taeko
T
Division of Hematology, Second Department of Internal Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Nakaseko
Chiaki
C
Hara
Satoru
S
Harima
Akane
A
Ejiri
Megumi
M
Yokota
Akira
A
Saito
Yasushi
Y
Nishimura
Miki
M
D000293:Adolescent; D001402:B-Lymphocytes / Q000821:virology; D002461:Cell Line, Transformed / Q000276:immunology; D002472:Cell Transformation, Viral; D002908:Chronic Disease; D016572:Cyclosporine / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood; D004351:Drug Resistance; D020031:Epstein-Barr Virus Infections / Q000276:immunology / Q000628:therapy*; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006525:Hepatitis, Viral, Human / Q000209:etiology / Q000821:virology; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009102:Multiple Organ Failure / Q000209:etiology; D036102:Peripheral Blood Stem Cell Transplantation; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D016559:Tacrolimus / Q000627:therapeutic use; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous
D004279:DNA, Viral; D007166:Immunosuppressive Agents; D005047:Etoposide; D016572:Cyclosporine; D016559:Tacrolimus