Allogeneic peripheral blood stem cell transplantation for the treatment of chronic active Epstein-Barr virus infection

• Published in: Bone marrow transplantation (Basingstoke) Vol. 26; no. 7; pp. 805 - 808
• Main Authors: FUJII, N, TAKENAKA, K, ISHIMARU, F, NIIYA, K, YOSHINO, T, HARADA, M, HIRAKI, A, MAEDA, Y, IKEDA, K, SHINAGAWA, K, ASHIBA, A, MUNEMASA, M, SUNAMI, K, HIRAMATSU, Y
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.10.2000
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood; Bone marrow; Bone marrow transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; Cell proliferation; Chemotherapy; Chronic Disease; Chronic infection; Deoxyribonucleic acid; DNA; DNA, Viral - blood; Epstein-Barr virus; Epstein-Barr Virus Infections - genetics; Epstein-Barr Virus Infections - therapy; Hematopoietic Stem Cell Transplantation; Hematopoietic stem cells; Hemorrhage; Histocompatibility antigen HLA; Humans; Immunotherapy, Adoptive; Leukocytes (mononuclear); Liver; Lymphocytes; Lymphocytes - virology; Male; Medical sciences; Natural killer cells; Peripheral blood mononuclear cells; RNA, Viral - blood; Stem cell transplantation; Stem cells; T-Lymphocytes, Cytotoxic - transplantation; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Homologous; Viruses; Gammaherpesvirinae; Human; Herpesviridae; Stem cell; Hematopoietic cell; Homograft; Male; Epstein Barr virus; Blood; Infection; Virus; Case study; Chronic; Treatment; Viral disease; Adult; Graft
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1702600

The prognosis of chronic active Epstein-Barr virus infection (CAEBV) is very poor. We describe a 24-year-old male with severe CAEBV who was treated with allogeneic peripheral blood stem cell transplantation (allo-PBSCT). On admission, EBER-1 in lymphocytes infiltrating the liver, EBV-DNA in peripheral blood mononuclear cells (PBMC) and monoclonal NK cell proliferation were confirmed. After unsuccessful chemotherapy, he received an allo-PBSCT from his HLA-identical sister. Although he died of pulmonary hemorrhage on day +19, EBV-DNA was undetectable by PCR in PBMC, and the post-mortem liver showed no EBER-1-positive lymphocytes. This experience suggests that EBV-positive lymphocytes in CAEBV may be eradicated by allo-PBSCT, thereby raising the possibility of a new treatment modality. Bone Marrow Transplantation (2000) 26, 805-808.