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Epstein–Barr virus-associated, CD20− polyclonal lymphoproliferative disorder after matched unrelated donor marrow transplantation

Bone Marrow Transplantation volume 34, pages 919–921 (2004)Cite this article

Post-transplant lymphoproliferative disorder (PTLD) is a well-recognized complication of allogeneic stem cell transplantation, with a cumulative incidence of 1% at 10 years. PTLDs occurring in the first 6–12 months after stem cell transplant usually manifest as clinically aggressive B-cell lymphomas of donor origin, and the majority of these cases are believed to express the B-cell-associated CD20 surface antigen, although only scarce data have been reported.1, 2 Most of these cases are associated with the Epstein–Barr virus (EBV). They can be polyclonal, oligoclonal, or (less commonly) monoclonal. Known risk factors for the development of early-onset PTLD include T-cell depletion of the graft, matched unrelated donor (MUD) or mismatched related donor transplant, antithymocyte globulin (ATG) therapy for prophylaxis or treatment of graft-versus-host disease (GVHD), and anti-CD3 monoclonal antibody therapy.1

PTLD is frequently fatal, particularly if not diagnosed at an early stage. Treatment options include chemotherapy, reduction of immunosuppression, and adoptive immunotherapy with donor leukocytes or donor-derived EBV-specific cytotoxic T-lymphocytes.2, 3 More recently, the anti-CD20 monoclonal antibody rituximab has been employed.4 We report a case of CD20− polyclonal EBV-associated PTLD.

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References

  1. Curtis RE, Travis LB, Rowlings PA et al. Risk of lymphoproliferative disorders after bone marrow transplantation: a multi-institutional study. Blood 1999; 94: 2208–2216.

    CAS  PubMed  Google Scholar 

  2. Wagner HJ, Rooney CM, Heslop HE . Diagnosis, treatment of posttransplantation lymphoproliferative disease after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2002; 8: 1–8.

    Article  CAS  PubMed  Google Scholar 

  3. Rooney CM, Smith CA, Ng CYC et al. Infusion of cytotoxic T cells for the prevention, treatment of Epstein–Barr virus-induced lymphoma in allogeneic transplant recipients. Blood 1998; 92: 1549–1555.

    CAS  PubMed  Google Scholar 

  4. Ferry CK, Maillard A, Agbalika F et al. Treatment of B-lymphoproliferative disorder after hematopoietic stem cell transplantation. Role, immunological follow-up of rituximab. Blood 2002; 100: 113a (abstr.).

    Google Scholar 

  5. van Esser JWJ, Niesters HGM, van der Holt B et al. Prevention of Epstein–Barr virus-lymphoproliferative disease by molecular monitoring and preemptive rituximab in high-risk patients after allogeneic stem cell transplantation. Blood 2002; 99: 4364–4369.

    Article  CAS  PubMed  Google Scholar 

  6. Anderson K, Bates M, Slaughenhoupt B et al. Expression of human B cell-associated antigens on leukemias and lymphomas: a model of human B cell differentiation. Blood 1984; 63: 1424–1433.

    CAS  PubMed  Google Scholar 

  7. O'Connell FP, Pinkus JL, Pinkus GS . CD138 (syndecan-1), a plasma cell marker immunohistochemical profile in hematopoietic and nonhematopoietic neoplasms. Am J Clin Pathol 2004; 121: 254–263.

    Article  PubMed  Google Scholar 

  8. Kaleem Z, Hassan A, Pathan MH, White G . Flow cytometric evaluation of posttransplant B-cell lymphoproliferative disorders. Arch Pathol Lab Med 2004; 128: 181–186.

    PubMed  Google Scholar 

  9. Gulley ML, Swinnen LJ, Paisance Jr KT et al. Tumor origin and CD20 expression in posttransplant lymphoproliferative disorder occurring in solid organ transplant recipients: implications for immune-based therapy. Transplantation 2003; 76: 959–964.

    Article  PubMed  Google Scholar 

  10. Capello D, Cerri M, Muti G et al. Molecular histogenesis of posttransplant lymphoproliferative disorders. Blood 2003; 102: 3775–3785.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Blood and Marrow Transplantation, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Boulevard – Unit 423, Houston, 77030, TX, USA

    P Anderlini & R E Champlin

  2. Hematopathology, The University of Texas, MD Anderson Cancer Center, Houston, 77030, TX, USA

    J R Valbuena & C E Bueso-Ramos

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  1. P Anderlini
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  2. J R Valbuena
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  3. R E Champlin
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  4. C E Bueso-Ramos
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Anderlini, P., Valbuena, J., Champlin, R. et al. Epstein–Barr virus-associated, CD20− polyclonal lymphoproliferative disorder after matched unrelated donor marrow transplantation. Bone Marrow Transplant 34, 919–921 (2004). https://doi.org/10.1038/sj.bmt.1704683

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