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Heterogeneity in clinical course of EBV-associated lymphoproliferative disorder after allogeneic stem cell transplantation |
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| Authors: | Sara C. Meyer Jörg P. Halter Helen Baldomero Hans H. Hirsch Alexandar Tzankov |
| Affiliation: | 1. Stem Cell Transplant TeamDivision of Hematology, University Hospital Basel, Basel, Switzerlandmedingerm@uhbs.ch meyers1@mskcc.org;2. Stem Cell Transplant TeamDivision of Hematology, University Hospital Basel, Basel, Switzerland;3. Department of PathologyUniversity Hospital Basel, Basel, Switzerland |
| Abstract: | Objective and Importance Post-transplant lymphoproliferative disorder (PTLD) is a severe complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) associated with Epstein–Barr virus (EBV). Clinical presentations Among 263 individuals treated with allo-HSCT for severe aplastic anemia, pure white cell aplasia, T-prolymphocytic leukemia, and relapsed Hodgkin lymphoma, we diagnosed EBV-PTLD in 5 patients. Median age was 29 years (range 19–70 years) and four of five patients were EBV-seropositive prior to HSCT. All five had unrelated EBV-positive donors. In all cases, PTLD occurred within the first year post-transplant (median 4 months). Intervention There were two rapidly fatal courses with extensive organ involvement. Both patients showed lymphopenia and thrombocytopenia. In contrast, the three surviving patients had higher lymphocytes and normal platelet counts, while PTLD was restricted to one site and resolved after 2–4 cycles of rituximab. Conclusion In this case series courses of PTLD showed substantial diversity. |
| Keywords: | Epstein–Barr virus Post-transplant lymphoproliferative disorder Hematopoietic stem cell transplantation |