Epstein-Barr Virus Associated Post-transplant Hodgkin Lymphoma in an Adult Patient after Cord Blood Stem Cell Transplantation for Acute Lymphoblastic Leukemia

• Published in: Journal of Clinical and Experimental Hematopathology Vol. 49; no. 1; pp. 45 - 51
• Main Authors: Okuno, Keisuke, Horie, Yasushi, Kanai, Kyosuke, Kato, Masako, Kuwamoto, Satoshi, Okazaki, Toshiro, Hayashi, Kazuhiko
• Format: Journal Article
• Language: English; Japanese
• Published: Japan The Japanese Society for Lymphoreticular Tissue Research 2009
• Subjects: cord blood stem cell transplantation; Cord Blood Stem Cell Transplantation - adverse effects; Diagnosis, Differential; Epstein-Barr virus; Epstein-Barr Virus Infections - etiology; Female; Herpesvirus 4, Human; Hodgkin Disease - diagnosis; Hodgkin Disease - etiology; Hodgkin Disease - virology; Hodgkin lymphoma; Humans; Neoplasms, Second Primary - drug therapy; Neoplasms, Second Primary - etiology; post-transplant lymphoproliferative disorders; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor Cell Lymphoblastic Leukemia-Lymphoma - etiology; Treatment Outcome; Young Adult
• ISSN: 1346-4280; 1880-9952
• DOI: 10.3960/jslrt.49.45

Post-transplant lymphoproliferative disorder (PTLD) is one of the most important complications of solid organ transplantation or hematopoietic stem cell transplantation. Most PTLDs are associated with Epstein-Barr virus (EBV) infection. Although post-transplant Hodgkin lymphoma (HL) is included in PTLD, there have been no studies in the literature on adult cases of post-transplant HL after cord blood stem cell transplantation (CBSCT). This is due to the fact that EBV infection of cord blood cells usually does not occur, and EBV-infected lymphocytes of the recipient should be eradicated by preconditioning therapy. We report a 26-year-old woman case of post-transplant HL, which occurred after CBSCT for relapsed acute lymphoblastic leukemia. Three years and eight months after CBSCT, the enlarged cervical lymph node was histologically diagnosed as EBV associated post-transplant HL, which showed immunophenotypes of classical HL and latency type II EBV infection. She underwent chemotherapy, and has survived 4 years and 6 months after CBSCT. Differential diagnosis of post-transplant HL with good prognosis and HL-like PTLD with aggressive behavior is important, and immunohistochemical methods were useful and essential for it. The source of EBV associated HL in this case will be discussed. [J Clin Exp Hematopathol 49(1) : 45-51, 2009]