Treatment of Epstein-Barr virus lymphoproliferative disease after hematopoietic stem-cell transplantation with hydroxyurea and cytotoxic T-cell lymphocytes

Samart Pakakasama, Gretchen M. Eames, Michael C. Morriss, M. Helen Huls, Cliona M. Rooney, Helen E. Heslop, Robert A. Krance

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Epstein-Barr virus (EBV) lymphoproliferative disease (LPD) is a potentially fatal complication that may follow allogeneic hematopoietic stem-cell transplantation (HSCT). In this article, the authors report a 2-year-old girl with Hurler's syndrome who developed multiple central nervous system (CNS) EBV LPD lesions 1 year after unrelated donor HSCT. Before this CNS occurrence, the patient had a complete response to rituximab treatment for EBV LPD of the spleen and lymph nodes; however, treatment of the CNS disease with rituximab proved ineffective. Because of reported favorable response of primary CNS EBV LPD in two human immunodeficiency virus-positive patients, the authors treated this patient with low-dose oral hydroxyurea. The patient improved clinically, with a decrease in size of multiple EBV LPD brain lesions. Subsequently, the patient received EBV-specific cytotoxic T-cell lymphocytes and remains well. The benefit and limited toxicity of hydroxyurea therapy merit its further consideration as treatment for EBV LPD.

Original languageEnglish (US)
Pages (from-to)755-757
Number of pages3
JournalTransplantation
Volume78
Issue number5
DOIs
StatePublished - Sep 15 2004

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Keywords

  • Cytotoxic T-cell lymphocytes
  • Epstein-Barr virus
  • Hematopoietic stem-cell transplantation
  • Hydroxyurea
  • Lymphoproliferative disease

ASJC Scopus subject areas

  • Transplantation

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