Discrepancy in EBV-DNA load between peripheral blood and cerebrospinal fluid in a patient with isolated CNS post-transplant lymphoproliferative disorder |
| |
Authors: | Hiroaki Shimizu Takayuki Saitoh Hiroko Koya Akinori Yuzuriha Takumi Hoshino Nahoko Hatsumi Satoru Takada Tomohito Nagaki Yoshihisa Nojima Toru Sakura |
| |
Institution: | (1) Department of Hematology, Saiseikai Maebashi Hospital, Kamishinden-machi 564-1, Maebashi Gunma, 371-0821, Japan;(2) Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan;(3) Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan |
| |
Abstract: | Post-transplant lymphoproliferative disorder (PTLD) is a fatal complication of allogeneic hematopoietic stem cell transplantation
(HSCT) that is caused by reactivation of Epstein–Barr virus (EBV). A successful approach, monitoring EBV-DNA load in peripheral
blood (PB) accompanied by preemptive rituximab therapy, has recently been reported. Here, we describe a 29-year-old woman
who developed isolated central nervous system (CNS) PTLD. She received HSCT against acute myelogenous leukemia from a related
human leukocyte antigen-haploidentical donor, following a conditioning regimen that included antithymocyte globulin. Tacrolimus
and methylprednisolone were given as prophylaxis for graft-versus-host disease. On day +172, the patient’s consciousness deteriorated.
Magnetic resonance imaging showed six ring-enhanced lesions in the cerebral hemispheres. These tumors were diagnosed, via
a craniotomy and tumorectomy, as PTLD. EBV-DNA load was elevated in the cerebrospinal fluid (CSF) but not detected in PB.
She was treated with whole-brain irradiation and rituximab, and achieved partial remission of the tumors. This case serves
as a reminder that vigilance is required regarding the development of isolated CNS PTLD; it is worth examining EBV-DNA replication
in CSF for diagnosis even when the EBV-DNA load is negative in PB. |
| |
Keywords: | |
本文献已被 PubMed SpringerLink 等数据库收录! |
|