Epstein-Barr virus-associated B cell lymphoproliferative disorder following mismatched related T cell-depleted bone marrow transplantation
| Autor: | N. P. Christiansen, Kuang-Yueh Chiang, K Bridges, Sunil Abhyankar, Henslee-Downey Pj, L. J. Hazlett, Lee C, R. S. Parrish, K. T. Godder, F. van Rhee |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Epstein-Barr Virus Infections Adolescent Lymphoproliferative disorders Graft vs Host Disease Human leukocyte antigen medicine.disease_cause Virus Herpesviridae Lymphocyte Depletion Risk Factors hemic and lymphatic diseases medicine Humans Child B cell Aged Bone Marrow Transplantation Transplantation B-Lymphocytes business.industry Incidence (epidemiology) Histocompatibility Testing Infant Hematology Middle Aged medicine.disease Epstein–Barr virus Lymphoproliferative Disorders surgical procedures operative medicine.anatomical_structure Child Preschool Immunology Female Bone marrow business |
| Zdroj: | Bone marrow transplantation. 28(12) |
| ISSN: | 0268-3369 |
| Popis: | Epstein–Barr virus (EBV) is closely associated with the progressive and often fatal lymphoproliferative disorders (LPD) in post bone marrow transplantation (BMT) and immunocompromised hosts. The incidence increases significantly when alternative donors or manipulation of marrow graft are used. A total of 318 consecutive BMT from partially mismatched related family donors (PMRD) were performed between February 1993 and June 1998. Known risk factors for the development of EBV-LPD were analyzed which included HLA mismatches, T cell depletion, antithymocyte globulin (ATG), and graft-versus-host disease (GVHD). Eighteen patients (5.7%) developed EBV-LPD at a median of 137 days post BMT (range 48–617). The estimated probability of developing EBV-LPD was 0.13 (95% CI 0.07–0.19) at 5 years. The incidence of grade II to IV GVHD was 19.2%, which translated into an increased trend of EBV-LPD. No correlation with other risk factors was observed. Treatment consisted of supportive antiviral agents, tapering of immunosuppressive regimens, donor leukocyte infusions and radiation. Three patients are alive and disease-free at a median follow-up of 69 months (range 36–71). We observed a lower than expected incidence of EBV-LPD despite existing multiple high-risk factors. We believe prevention and early control of GVHD may contribute to this finding. Bone Marrow Transplantation (2001) 28, 1117–1123. |
| Databáze: | OpenAIRE |
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