Manifestations of Fulminant CD8 T-cell Post-transplant Lymphoproliferative Disorder Following the Administration of Rituximab for Lymphadenopathy with a High Level of Epstein-Barr Virus (EBV) Replication after Allogeneic Hematopoietic Stem Cell Transplantation

作者：Tanaka Tomoyuki^*; Takizawa Jun; Miyakoshi Shukuko; Kozakai Takashi; Fuse Kyoko; Shibasaki Yasuhiko; Moriyama Masato; Ohshima Koichi; Toba Ken; Furukawa Tatsuo; Sone Hirohito; Masuko Masayoshi

来源：Internal Medicine, 2014, 53(18): 2115-2119.

DOI：10.2169/internalmedicine.53.2384

• Epstein-Barr virus
• post-transplant lymphoproliferative disorder
• CD8 T-cell
• rituximab
• hematopoietic stem cell transplantation

We herein report the case of a 22-year-old woman with severe aplastic anemia who underwent allogeneic hematopoietic stem cell transplantation (HSCT). After HSCT, the Epstein-Barr virus (EBV)-DNA load in the peripheral blood gradually increased, and the patient presented with a fever and lymphadenopathy on day 56 post-HSCT. Although we administered rituximab, her clinical condition worsened. After rituximab treatment, CD8 T-cells emerged and became dominant in the peripheral blood, some of which were positive on an EBV-specific tetramer analysis. However, an open biopsy of the lymphadenopathy lesions revealed the CD8 T-cells to be infected with EBV, exhibiting proliferation with oligoclonality. The patient ultimately died of multiple organ failure on day 99 post-HSCT.

• 出版日期2014