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Am J Hematol ; 76(4): 368-72, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15282671

ABSTRACT

Chronic active Epstein-Barr virus infection (CAEBV) is a heterogeneous EBV-related disorder, ranging from mild/moderate forms to rapidly lethal disorders. The lethal form of CAEBV is characterized by multiple organ failure, hemophagocytic syndrome, and development of lymphomas. Allogeneic stem cell transplantation is considered as the only potentially curative treatment for the lethal form of CAEBV, but it is not always desirable because of the high incidence of regimen-related toxicities. A 17-year-old female with CAEBV, who was refractory to conventional therapies and considered to be unable to receive a myeloablative regimen because of multiple organ dysfunction, underwent allogeneic nonmyeloablative stem cell transplantation (allo-NST) before developing a hematological malignancy. She has been well without any signs of CAEBV for 27 months after allo-NST, and we confirmed that specific cytotoxic T lymphocyte activity against EBV was reconstituted. This outcome suggests that allo-NST can control CAEBV by reconstituting the host immunity against EBV.


Subject(s)
Epstein-Barr Virus Infections/therapy , Peripheral Blood Stem Cell Transplantation , Transplantation Conditioning/methods , Adolescent , B-Lymphocytes/virology , Cell Line, Transformed/immunology , Cell Transformation, Viral , Chronic Disease , Cyclosporine/therapeutic use , DNA, Viral/blood , Drug Resistance , Epstein-Barr Virus Infections/immunology , Etoposide/therapeutic use , Female , Hepatitis, Viral, Human/etiology , Hepatitis, Viral, Human/virology , Herpesvirus 4, Human/immunology , Humans , Immunosuppressive Agents/therapeutic use , Multiple Organ Failure/etiology , T-Lymphocytes, Cytotoxic/immunology , Tacrolimus/therapeutic use , Transplantation, Homologous
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