title: Examining the origin of posttransplant lymphoproliferative disorder in a patient after a second allogeneic hematopoeitic stem cell transplantation for relapsed BCR-ABL positive acute lymphoblastic leukemia.
abstract: BACKGROUND
  Posttransplant lymphoproliferative disease (PTLD) is a serious complication because of the reactivation of the Epstein-Barr virus (EBV). Although after solid organ transplantation (SOT) EBV is typically of recipient origin, after hematopoietic stem cell transplantation (HSCT) donor-derived B cells are usually the source of the EBV-induced lymphoproliferation.
  
  
  METHODS
  We report a unique presentation of an EBV-associated PTLD in a 13-year-old boy who underwent 2 subsequent HSCTs from 2 different-sex donors for BCR-ABL-positive acute lymphoblastic leukemia (ALL) and relapses of leukemia, respectively. The PTLD tissue was analyzed for the origin of both B cells and T cells of the lesion. Chimerism analysis done with short tandem repeat systems (STR) showed no autologous signals; approximately 50% of the cells were from the first and second donors, respectively. XY-fluorescence in situ hybridization showed a B-cell PTLD originating from the first donor surrounded by T cells from the second donor.
  
  
  CONCLUSIONS
  This case shows that EBV-infected B cells from a first donor can be the source of a PTLD after a second myeloablative HSCT from a different donor.
authors.affiliation: Department of Pediatric Hematology and Oncology, Justus-Liebig University, Giessen, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ruf
authors.forename: Olga
authors.initials: O
authors.lastname: Moser
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Wössmann
authors.forename: Hermann
authors.initials: H
authors.lastname: Kreyenberg
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D001402:B-Lymphocytes / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D016044:Fusion Proteins, bcr-abl / Q000235:genetics*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000628:therapy* / Q000821:virology; D012008:Recurrence; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: C406060:abl-bcr fusion protein, human; D016044:Fusion Proteins, bcr-abl