title: EBV lymphoproliferative disease of host origin after haploidentical stem cell transplantation.
abstract: Post-transplant lymphoproliferative disease (PTLPD), due to the reactivation of Epstein-Barr virus (EBV), is a serious complication. The risk of the disorder increases with T-cell depletion methods, mismatched hematopoietic stem cell transplantation (HSCT), graft-versus-host disease (GVHD), and immunosuppression. In contrast to solid organ transplantation, where EBV is typically of recipient origin, the source of the EBV in HSCT recipients is donor-derived B-lymphocytes. In this report, we describe a 15-year-old girl who underwent HSCT from her father as treatment for acute myeloid leukemia (AML). She subsequently developed disseminated PTLPD involving multiple organ and nodal sites. Her neoplastic lymphoblasts were host-derived and refractory to rituximab treatment due to lack of CD20 expression.
authors.affiliation: Department of Hematology/Oncology, Division of Stem Cell Transplantation, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA. kimberly.kasow@stjude.org
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kasow
authors.forename: Wing
authors.initials: W
authors.lastname: Leung
authors.forename: Edwin M
authors.initials: EM
authors.lastname: Horwitz
authors.forename: Paul
authors.initials: P
authors.lastname: Woodard
authors.forename: Rupert
authors.initials: R
authors.lastname: Handgretinger
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hale
mesh_terms: D000293:Adolescent; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000096:biosynthesis; D000970:Antineoplastic Agents; D004351:Drug Resistance; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation; D004854:Herpesvirus 4, Human; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000628:therapy / Q000821:virology; D008232:Lymphoproliferative Disorders / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D000069283:Rituximab; D014184:Transplantation, Homologous
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000970:Antineoplastic Agents; D000069283:Rituximab