Early identification of Epstein‐Barr virus‐associated post‐transplantation lymphoproliferative disease

TLDR

Epstein‑Barr virus‑associated lymphoproliferative disease is a common, usually fatal complication after bone‑marrow transplantation from HLA‑matched or mismatched unrelated donors. The study aimed to identify methods enabling early detection of patients at high risk for EBV‑LPD to improve therapeutic outcomes. The authors evaluated ex vivo outgrowth of transformed B lymphocytes and EBV DNA PCR detection as potential early‑identification techniques. Both assays were significantly associated with EBV‑LPD diagnosis, with 100% correlation for B‑cell outgrowth and 80% for PCR, allowing detection before clinical disease onset and enabling early intervention.

Abstract

Epstein-Barr virus-associated lymphoproliferative disease (EBV-LPD) is a common, usually fatal, complication developing after transplantation of bone marrow from HLA-mismatched or HLA-matched unrelated donors. Prompted by recent reports of successful treatment of EBV-LPD, we investigated methods which could result in early identification of patients at high risk for this disorder, thus improving the likelihood of successful therapeutic interventions. Both the outgrowth of transformed B lymphocytes ex vivo (100% correlation) and the detection of EBV DNA by a PCR method (80% correlation) showed statistically significant association with the histopathological diagnosis of EBV-LPD. Because these abnormalities can be detected prior to the onset of clinical disease. It should now be possible to use a combination of the methods described here to identify patients at high risk of developing EBV-LPD, thus enabling early therapeutic intervention.