title: Rapidly progressive Epstein-Barr virus-associated lymphoproliferative disorder unpredictable by weekly viral load monitoring.
abstract: We report a case of Epstein-Barr virus (EBV)-associated lymphoproliferative disease (LPD) following unrelated bone marrow transplantation (UBMT) for severe aplastic anemia treated with a conditioning regimen that included anti-thymocyte globulin (ATG). The patient showed signs of EBV reactivation as early as 34 days after UBMT. Our weekly schedule for EBV monitoring failed to trace rapid changes in EBV viral load and the patient eventually developed EBV-LPD. However, early intervention with monoclonal antibody against CD20, rituximab, stopped the further progression of EBV-LPD. As several recent reports have suggested, the safety and efficacy of rituximab treatment for EBV-LPD is supported by our limited experience with post transplant EBV-LPD.
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo.
authors.forename: Shihoko
authors.initials: S
authors.lastname: Wakabayashi
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
authors.forename: Ryo
authors.initials: R
authors.lastname: Hanajiri
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamashita
authors.forename: Hideki
authors.initials: H
authors.lastname: Akiyama
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
mesh_terms: D000741:Anemia, Aplastic / Q000628:therapy; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000961:Antilymphocyte Serum / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D004279:DNA, Viral / Q000097:blood; D018450:Disease Progression; D020031:Epstein-Barr Virus Infections / Q000209:etiology / Q000628:therapy / Q000821:virology*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000628:therapy / Q000821:virology*; D008297:Male; D000069283:Rituximab; D013997:Time Factors; D019172:Transplantation Conditioning / Q000009:adverse effects; D014184:Transplantation, Homologous; D019562:Viral Load; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000961:Antilymphocyte Serum; D004279:DNA, Viral; D000069283:Rituximab