Epstein-Barr virus-related lymphoproliferative disorders following bone marrow transplantation: an immunologic and genotypic analysis.

D. D. Davey, D. Kamat, M. Laszewski, J. A. Goeken, J. D. Kemp, M. E. Trigg, D. T. Purtilo, J. Davis, F. R. Dick

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Four patients from 1.5 to 18 yr of age who had received partially matched T-cell-depleted bone marrow transplants for acute leukemia succumbed to a widespread lymphoproliferative disorder (LPD) at 56 to 147 days after transplant. Premortem diagnosis of LPD was suggested in two because plasmacytoid cells were observed in the blood and bone marrow, and in the cerebrospinal fluid of one of these patients. Serum clonal immunoglobulins (Igs) were also demonstrated in these two patients premortem, while the other two had clonal Igs in serum obtained at autopsy. Autopsies revealed a plasmacytoid infiltrate or immunoblastic lymphoma involving lymph nodes, spleen, liver, lungs, gastrointestinal tract, and kidneys. Immunoglobulin gene rearrangement studies performed in three revealed B-cell clonality. Both immunohistochemical and DNA gene rearrangement studies were useful in differentiating the LPD from the pretransplant leukemia. Epstein-Barr virus (EBV) genome was found in the tissues of the three patients studied. The diagnosis of EBV-induced LPD must be considered in bone marrow transplant patients who deteriorate and who exhibit serum clonal Igs or prominent plasmacytoid cells in laboratory specimens.

Original languageEnglish (US)
Pages (from-to)27-34
Number of pages8
JournalModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
Volume2
Issue number1
StatePublished - Jan 1989
Externally publishedYes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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