scholarly journals Colonic EBV-Associated Lymphoproliferative Disorder in a Patient Treated with Rabbit Antithymocyte Globulin for Aplastic Anemia

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Hiroko Sugimoto-Sekiguchi ◽  
Haruko Tashiro ◽  
Ryosuke Shirasaki ◽  
Tomio Arai ◽  
Tadashi Yamamoto ◽  
...  
Keyword(s):  
Viral Load ◽  
Aplastic Anemia ◽  
Immunosuppressive Therapy ◽  
Lymphoproliferative Disorder ◽  
Antithymocyte Globulin ◽  
White Blood Cells ◽  
Barr Virus ◽  
Rabbit Antithymocyte Globulin ◽  
Single Use ◽  
Epstein Barr

Epstein-Barr-virus- (EBV-) associated lymphoproliferative disorder (LPD) after immunosuppressive therapy for aplastic anemia (AA), in a nontransplant setting, has not been well described. We report one case of colonic EBV-LPD after a single course of immunosuppressive therapy for AA. The patient developed multiple colonic tumors 3 months after receiving immunosuppressive therapy, which consisted of rabbit antithymocyte globulin (ATG), cyclosporine, and methyl-predonisolone. The histological findings of biopsy specimens revealed that atypical lymphocytes had infiltrated colonic glands. Immunohistochemical staining for CD20 was positive, andin situhybridization for EBV-encoded small RNAs was also positive. The EBV viral load in peripheral blood was slightly increased to 140/106white blood cells. After the cessation of immunosuppressant, the colonic tumors spontaneously regressed, and the EBV viral load decreased to undetectable levels. This is the first report of the single use of rabbit ATG inducing colonic EBV-LPD. Because a single use of immunosuppressive therapy containing rabbit ATG can cause EBV-LPD, we should carefully observe patients receiving rabbit ATG for AA.

Reactivation and dynamics of cytomegalovirus and Epstein‐Barr virus after rabbit antithymocyte globulin and cyclosporine for aplastic anemia

2019 ◽  
Vol 103 (4) ◽  
pp. 433-441 ◽  
Author(s):  
Sung‐Soo Park ◽  
Sung‐Yeon Cho ◽  
Eunhee Han ◽  
Gi June Min ◽  
Silvia Park ◽  
...  
Keyword(s):  
Aplastic Anemia ◽  
Antithymocyte Globulin ◽  
Epstein Barr Virus ◽  
Barr Virus ◽  
Rabbit Antithymocyte Globulin ◽  
Epstein Barr

Successful Treatment of Epstein-Barr Virus-Associated Lymphoproliferative Disorder with Rituximab in a Patient Undergoing Immunosuppressive Therapy for Aplastic Anemia

2016 ◽  
Vol 136 (3) ◽  
pp. 174-177
Author(s):  
Hiroaki Shimizu ◽  
Nobuhiko Kobayashi ◽  
Masahiro Mihara ◽  
Hirono Iriuchishima ◽  
Takuma Ishizaki ◽  
...  
Keyword(s):  
Aplastic Anemia ◽  
Immunosuppressive Therapy ◽  
Lymphoproliferative Disorder ◽  
Epstein Barr Virus ◽  
Transplant Recipients ◽  
Allogeneic Transplant ◽  
Barr Virus ◽  
Systemic Lymphadenopathy ◽  
Ebv Dna ◽  
Epstein Barr

Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD) is a currently emerging serious complication in immunosuppressed patients, especially in allogeneic transplant recipients. Several fatal cases of EBV-LPD have been reported in aplastic anemia (AA) patients receiving immunosuppressive therapy (IST) with antithymocyte globulin (ATG) plus cyclosporine A (CsA), but no appropriate prophylactic or therapeutic strategy has been established. Herein, we describe a 29-year-old man whose EBV-LPD was successfully treated with rituximab. He received IST with ATG plus CsA for hepatitis-associated AA. EBV-DNA in plasma, which was not detectable before IST, gradually increased after IST initiation. A high fever and systemic lymphadenopathy developed 31 days after IST initiation. An EBV-DNA titer of 5.7 × 105 copies/μl was detected, and a diagnosis of EBV-LPD was made. Although discontinuation of IST was not effective, a single dose of rituximab on day 33 resolved the clinical symptoms and completely eliminated EBV-DNA. Even after restarting CsA administration, no elevation of EBV-DNA was observed, and his complete blood cell count had fully recovered 1 year after IST. This case suggests that this treatment strategy for EBV-LPD with EBV-DNA monitoring and rituximab administration, which has been recommended in allogeneic transplant recipients, may also be useful in the context of AA patients receiving IST.

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