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- Title
Unrelated bone marrow transplantation for Epstein-Barr virus-associated T/NK-cell lymphoproliferative disease.
- Authors
Okamura, T; Kishimoto, T; Inoue, M; Honda, M; Yamashita, N; Wakiguchi, H; Yagita, M; Hosoi, G; Sako, M; Yasui, M; Yagi, K; Kawa, K
- Abstract
Epstein-Barr virus (EBV)-associated T/NK-cell lymphoproliferative disease (LPD) has been linked to several different disorders, including chronic active EBV infection, EBV-associated hemophagocytic syndrome, hypersensitivity to mosquito bites, hydroa vacciniforme, aggressive NK-cell leukemia, and nasal/nasal-type NK-cell lymphoma. In most instances, these disorders are refractory to conventional treatments and have a poor prognosis. Here, we report a new treatment strategy for EBV-associated T/NK-cell LPD, consisting of immunochemotherapy, intensive combination chemotherapy, and stem cell transplantation. The five patients studied, two with T-cell and three with NK-cell LPD, lacked a human leukocyte antigen-matched, related donor, and therefore received bone marrow grafts from HLA-matched, unrelated donors. The preconditioning regimen consisted of total-body irradiation (12?Gy), etoposide (900?mg/m2), and cyclophosphamide (120?mg/kg) or melphalan (210?mg/m2). All patients had residual LPD by a quantitative PCR technique prior to transplantation. After unrelated bone marrow transplantation (UBMT), four of the five patients remain in continuous complete remission at a median of 19 months, without detectable EBV-DNA in peripheral blood. Thus, UBMT appears to be a reasonable option for the treatment of patients with EBV-associated T/NK-cell LPD. Detection of EBV-DNA by PCR offers an important tool for assessing minimal residual disease in patients with EBV-associated T/NK-cell LPD.Bone Marrow Transplantation (2003) 31, 105-111. doi:10.1038/sj.bmt.1703796
- Subjects
BONE marrow transplantation; EPSTEIN-Barr virus; LYMPHOPROLIFERATIVE disorders
- Publication
Bone Marrow Transplantation, 2003, Vol 31, Issue 2, p105
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/sj.bmt.1703796