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Menezes ACDS, Alves LDB, Ramos GDA, Schirmer MR, Moreira MCR, Piragibe MMM, de Melo AC, Antunes HS. The multiple presentation of oral actinomycosis in post-hematopoietic stem cell transplantation patients: case series. Hematol Transfus Cell Ther 2023:S2531-1379(23)02597-X. [PMID: 38182467 DOI: 10.1016/j.htct.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/09/2023] [Indexed: 01/07/2024] Open
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2
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Bruno JS, Miranda-Silva W, Heidrich V, Gonçalves MDC, Novis Y, Arrais-Rodrigues C, Camargo AA, Fregnani ER. Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report. BMC Oral Health 2023; 23:62. [PMID: 36732789 PMCID: PMC9893679 DOI: 10.1186/s12903-023-02777-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplant (allo-HSCT) is used to treat several hematological diseases, but immunosuppression during allo-HSCT facilitates opportunistic microbial growth in tissues, such as actinomycosis. An effective diagnosis of opportunistic diseases is essential for correct management of the disease and preservation of the immunosuppressed patient's life. CASE DESCRIPTION A 57-year-old female patient was diagnosed with extranodal nasal type NK/T cell lymphoma and underwent curative treatment with allo-HSCT. Twenty-one days after the last clinical follow-up, the patient presented a necrotizing lesion in the papilla region between the first and second molars of the second quadrant. Histopathological analysis showed the presence of a bacterial cluster consistent with Actinomyces infection, and a dense lymphoid infiltrate was also observed. Immunohistochemistry for CD20, CD3, and CD56 was performed to exclude the possibility of the recurrence of extranodal NK/T cell lymphoma. Oral microbiota profiling showed a huge increase in the abundance of Actinomyces bacteria in the subgingival region three weeks prior to appearance of the lesion. CONCLUSIONS Opportunistic infections with an unusual clinical appearance are confounding factors in therapeutic decision-making. We present for the first time a case of actinomycosis in the gingival papilla region following allo-HSCT. We also highlight how microbiota profiling through next-generation sequencing could be used to anticipate bacterial infection diagnosis.
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Affiliation(s)
- Julia Stephanie Bruno
- grid.413471.40000 0000 9080 8521Centro de Oncologia Molecular, Hospital Sírio-Libanês, São Paulo, SP Brazil
| | - Wanessa Miranda-Silva
- grid.413471.40000 0000 9080 8521Centro de Oncologia Molecular, Hospital Sírio-Libanês, São Paulo, SP Brazil
| | - Vitor Heidrich
- grid.413471.40000 0000 9080 8521Centro de Oncologia Molecular, Hospital Sírio-Libanês, São Paulo, SP Brazil ,grid.11899.380000 0004 1937 0722Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo, SP Brazil
| | | | - Yana Novis
- grid.413471.40000 0000 9080 8521Centro de Oncologia, Hospital Sírio-Libanês, São Paulo, SP Brazil
| | - Celso Arrais-Rodrigues
- Hospital Nove de Julho, Rede DASA, São Paulo, SP Brazil ,grid.411249.b0000 0001 0514 7202Universidade Federal de São Paulo, São Paulo, SP Brazil
| | - Anamaria Aranha Camargo
- grid.413471.40000 0000 9080 8521Centro de Oncologia Molecular, Hospital Sírio-Libanês, São Paulo, SP Brazil
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3
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Peng YY, Xiong YY, Zhang LX, Wang J, Zhang HB, Xiao Q, Guo SL. Allogeneic Hematopoietic Stem Cell Transplantation in Extranodal Natural Killer/T-cell Lymphoma. Turk J Haematol 2021; 38:126-137. [PMID: 33535731 PMCID: PMC8171200 DOI: 10.4274/tjh.galenos.2021.2020.0438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective Extranodal NK/T-cell lymphoma (ENKL) is aggressive and resistant to chemotherapy and radiotherapy. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for high-risk lymphomas owing to its associated graft-versus-lymphoma (GVL) effect. However, its application to ENKL is limited. We aim to summarize the characteristics of allo-HSCT for ENKL and, more importantly, evaluate whether allo-HSCT could offer any benefits for ENKL. Materials and Methods A systematic review and data analysis were performed to evaluate the performance of allo-HSCT in the treatment of ENKL using studies obtained from PubMed, Medline, and Embase from January 2000 to December 2019 in the English language. Results A total of 136 cases from 17 eligible publications were included in this study. It was found that after allo-HSCT, with an average follow-up time of 34 months (range: 1-121 months), 37.5% (52) of 136 patients had acute graft-versus-host disease (GVHD) and 31.6% (43) had chronic GVHD. Furthermore, 35.3% (48) of the patients were reported to have relapsed, but 2 of those relapsed only locally and achieved complete remission (CR) again with additional irradiation, chemotherapy, and donor lymphocyte infusions for one and rapid tapering and discontinuation of cyclosporine for the other, earning more than one year of extra survival. Finally, of the 136 patients, 51.5% (70) died because of primary disease progression (42.9%), infection (20.0%), GVHD (11.4%), organ failure (7.1%), hemorrhage (4.3%), and other causes (not specified/unknown) (14.3%). Conclusion Allo-HSCT may be a treatment option for advanced or relapsed/refractory ENKL, but its role still requires more rigorous future studies.
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Affiliation(s)
- Yin-yin Peng
- First Affiliated Hospital of Chongqing Medical University, Department of Hematology, Chongqing, China
| | - Yi-ying Xiong
- First Affiliated Hospital of Chongqing Medical University, Department of Hematology, Chongqing, China
| | - Li-xia Zhang
- First Affiliated Hospital of Chongqing Medical University, Department of Hematology, Chongqing, China
| | - Jing Wang
- First Affiliated Hospital of Chongqing Medical University, Department of Hematology, Chongqing, China
| | - Hong-bin Zhang
- First Affiliated Hospital of Chongqing Medical University, Department of Hematology, Chongqing, China
| | - Qing Xiao
- First Affiliated Hospital of Chongqing Medical University, Department of Hematology, Chongqing, China
| | - Shu-liang Guo
- First Affiliated Hospital of Chongqing Medical University, Department of Respiratory Medicine, Chongqing, China
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4
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Ramos GDA, Piragibe MMM, Moreira MCR, Antunes HS. Polymicrobial infection of the oral mucosa after hematopoietic stem cell transplantation. Case report. Hematol Transfus Cell Ther 2019; 41:360-364. [PMID: 31582339 PMCID: PMC6978486 DOI: 10.1016/j.htct.2019.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/24/2018] [Accepted: 02/18/2019] [Indexed: 11/16/2022] Open
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5
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Barraco F, Labussière-Wallet H, Valour F, Ducastelle-Leprêtre S, Nicolini FE, Thomas X, Ferry T, Dumitrescu O, Michallet M, Ader F. Actinomycosis after allogeneic hematopoietic stem cell transplantation despite penicillin prophylaxis. Transpl Infect Dis 2016; 18:595-600. [PMID: 27203624 DOI: 10.1111/tid.12549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 02/06/2016] [Accepted: 02/29/2016] [Indexed: 11/26/2022]
Abstract
Actinomycosis is a rare chronic and multifaceted disease caused by Actinomyces species frequently mimicking malignancy or other chronic granulomatous lung diseases. We report 4 original presentations of actinomycosis arising under supposed penicillin prophylaxis in allogeneic stem cell transplantation recipients.
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Affiliation(s)
- F Barraco
- Departement d'Hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - H Labussière-Wallet
- Departement d'Hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - F Valour
- Departement de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Inserm U1111 Centre International de Recherche en Infectiologie (CIRI), Université Claude Bernard Lyon 1, Lyon, France
| | - S Ducastelle-Leprêtre
- Departement d'Hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - F-E Nicolini
- Departement d'Hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Inserm U1052, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Lyon, France
| | - X Thomas
- Departement d'Hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - T Ferry
- Departement de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Inserm U1111 Centre International de Recherche en Infectiologie (CIRI), Université Claude Bernard Lyon 1, Lyon, France
| | - O Dumitrescu
- Inserm U1111 Centre International de Recherche en Infectiologie (CIRI), Université Claude Bernard Lyon 1, Lyon, France.,Laboratoire de Microbiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - M Michallet
- Departement d'Hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - F Ader
- Departement de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Inserm U1111 Centre International de Recherche en Infectiologie (CIRI), Université Claude Bernard Lyon 1, Lyon, France
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6
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Nagaraju SP, Kirpalani DA, Bhabhe AS, Prasad R, Shah H, Kirpalani AL. Esophageal actinomycosis in a patient with end-stage renal disease. Hemodial Int 2014; 18:544-6. [DOI: 10.1111/hdi.12124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Aditya S. Bhabhe
- Department of Nephrology; Bombay Hospital and Research Institute; Mumbai India
| | - Raghvendra Prasad
- Department of Nephrology; Bombay Hospital and Research Institute; Mumbai India
| | - Hardik Shah
- Department of Nephrology; Bombay Hospital and Research Institute; Mumbai India
| | - Ashok L. Kirpalani
- Department of Nephrology; Bombay Hospital and Research Institute; Mumbai India
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7
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Kim HS, Cheon JW, Kim MS, Jung CK, Kim KR, Choi JW, Kang DW, Kim SY. A Case of Esophageal Actinomycosis in a Patient with Normal Immunity. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2013; 61:93-6. [DOI: 10.4166/kjg.2013.61.2.93] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Hyun Soo Kim
- Department of Internal Medicine, DongKang Medical Center, Ulsan, Korea
| | - Jong Woon Cheon
- Department of Internal Medicine, DongKang Medical Center, Ulsan, Korea
| | - Min Su Kim
- Department of Internal Medicine, DongKang Medical Center, Ulsan, Korea
| | - Chang Kil Jung
- Department of Internal Medicine, DongKang Medical Center, Ulsan, Korea
| | - Kyung Rok Kim
- Department of Internal Medicine, DongKang Medical Center, Ulsan, Korea
| | - Jae Won Choi
- Department of Internal Medicine, DongKang Medical Center, Ulsan, Korea
| | - Dong Woo Kang
- Department of Internal Medicine, DongKang Medical Center, Ulsan, Korea
| | - Sun Young Kim
- Department of Pathology, DongKang Medical Center, Ulsan, Korea
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8
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Ennishi D, Maeda Y, Fujii N, Kondo E, Shinagawa K, Ikeda K, Ichimura K, Yoshino T, Tanimoto M. Allogeneic hematopoietic stem cell transplantation for advanced extranodal natural killer/T-cell lymphoma, nasal type. Leuk Lymphoma 2011; 52:1255-61. [PMID: 21599584 DOI: 10.3109/10428194.2011.572322] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The prognosis for patients with advanced or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKL) is extremely poor. Thus, allogeneic stem cell transplantation (allo-HSCT) should be considered for this disease. However, reports of allo-HSCT for ENKL are limited because of the rarity of the disease. Here, we describe the clinical course of 12 cases of advanced and refractory ENKL treated with allo-HSCT, including five cases with cord blood transplant. With a median follow-up of 13 months (range, 1-168 months), seven patients are alive in remission, five have died, and one treatment-related death occurred. All patients with disease progression at transplant died of disease progression, whereas seven of eight patients with a complete or partial response are long-term survivors. Allo-HSCT is a feasible and promising consolidation therapy for advanced and relapsed ENKL. The disease status before allo-HSCT is well associated with general outcome, and thus induction treatment is very important for this disease.
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Affiliation(s)
- Daisuke Ennishi
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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9
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Li M, Gao C, Li H, Wang Z, Cao Y, Huang W, Li X, Wang S, Yu L, Da W. Allogeneic haematopoietic stem cell transplantation as a salvage strategy for relapsed or refractory nasal NK/T-cell lymphoma. Med Oncol 2010; 28:840-5. [DOI: 10.1007/s12032-010-9532-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Accepted: 04/07/2010] [Indexed: 10/19/2022]
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10
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Murchan EM, Redelman-Sidi G, Patel M, DiMaio C, Seo SK. Esophageal actinomycosis in a fifty-three-year-old man with HIV: case report and review of the literature. AIDS Patient Care STDS 2010; 24:73-8. [PMID: 20059353 DOI: 10.1089/apc.2009.0185] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Patients with advanced HIV infection commonly present with esophageal symptomatology most frequently due to Candida, cytomegalovirus, or herpes simplex virus. We present a case of a 53-year-old man with AIDS and prior esophageal candidiasis and oral aphthous ulcerations, who developed actinomycosis of the esophagus. This article aims to review clinical characteristics of this and seven previously reported cases occurring in HIV-infected patients. Esophageal actinomycosis is frequently preceded by other esophageal disease that likely results in breach of the mucosal barrier, allowing establishment of the infection. Health care providers should be aware of this rare entity, particularly in those with recurring symptoms, so that a timely diagnosis can be made.
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Affiliation(s)
- Erin M. Murchan
- Department of Medicine, New York University, New York, New York
| | - Gil Redelman-Sidi
- Department of Medicine, Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Minal Patel
- Department of Medicine, Gastroenterology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Christopher DiMaio
- Department of Medicine, Gastroenterology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Susan K. Seo
- Department of Medicine, Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York, New York
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11
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Sato E, Ohga S, Kuroda H, Yoshiba F, Nishimura M, Nagasawa M, Inoue M, Kawa K. Allogeneic hematopoietic stem cell transplantation for Epstein-Barr virus-associated T/natural killer-cell lymphoproliferative disease in Japan. Am J Hematol 2008; 83:721-7. [PMID: 18626884 DOI: 10.1002/ajh.21247] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Epstein-Barr virus (EBV)-associated T/NK-cell lymphoproliferative disease (LPD) has been linked to several different disorders. Its prognosis is generally poor and a treatment strategy has yet to be established. There are reports, however, that hematopoietic stem cell transplantation (HSCT) can cure this disease. To clarify the current situation regarding allogeneic hematopoietic stem cell transplantation (allo-HSCT) for EBV-associated T/NK-LPD, a nationwide survey was performed in Japan. Data for 74 patients were collected. There were 42 cases of chronic active EBV infection (CAEBV), 10 cases of EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH), and 22 cases of EBV-associated lymphoma/leukemia (EBV-lymphoma/leukemia). Of those with CAEBV, 54% had the EBV-infected T-cell type and 59% with EBV-lymphoma/leukemia had the EBV-infected NK-cell type. Most patients with EBV-HLH and EBV-lymphoma/leukemia received allo-HSCT within 1 year after onset compared to only 14% of patients with CAEBV. The event-free survival (EFS) rate following allo-HSCT was 0.561 +/- 0.086 for CAEBV, 0.614 +/- 0.186 for EBV-HLH, and 0.309 +/- 0.107 for EBV-lymphoma/leukemia. The EFS of allo-HSCT with conventional conditioning was 0.488 +/- 0.074 and with reduced-intensity conditioning was 0.563 +/- 0.124. Thus, in a substantial number of cases, EBV-associated T/NK-LPD can be cured by either allogeneic conventional stem cell transplantation or reduced-intensity stem cell transplantation.
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MESH Headings
- Adolescent
- Adult
- Child
- Child, Preschool
- Chronic Disease
- Combined Modality Therapy
- Disease-Free Survival
- Epstein-Barr Virus Infections/complications
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Infant
- Japan/epidemiology
- Killer Cells, Natural/pathology
- Leukemia, Large Granular Lymphocytic/epidemiology
- Leukemia, Large Granular Lymphocytic/pathology
- Leukemia, Large Granular Lymphocytic/surgery
- Leukemia, Large Granular Lymphocytic/virology
- Lymphohistiocytosis, Hemophagocytic/etiology
- Lymphoma, Non-Hodgkin/epidemiology
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, Non-Hodgkin/surgery
- Lymphoma, Non-Hodgkin/virology
- Lymphoproliferative Disorders/drug therapy
- Lymphoproliferative Disorders/epidemiology
- Lymphoproliferative Disorders/pathology
- Lymphoproliferative Disorders/surgery
- Lymphoproliferative Disorders/virology
- Male
- Middle Aged
- T-Lymphocytes/pathology
- Transplantation Conditioning
- Transplantation, Homologous
- Treatment Outcome
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Affiliation(s)
- Emiko Sato
- Department of Pediatrics, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodo-cho, Izumi, Osaka, Japan.
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Toubo T, Suga N, Ohga S, Nomura A, Onoe Y, Takada H, Hara T. Successful Unrelated Cord Blood Transplantation for Epstein-Barr Virus-Associated Lymphoproliferative Disease with Hemophagocytic Syndrome. Int J Hematol 2004; 80:458-62. [PMID: 15646660 DOI: 10.1532/ijh97.04081] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report a case of successful umbilical cord blood transplantation (CBT) for Epstein-Barr virus (EBV)-associated lymphoproliferative disease (LPD) in a 6-year-old girl. The patient had hemophagocytic syndrome with excessive circulating levels of EBV DNA that was refractory to immunochemotherapy. Multiple hepatosplenic lesions favored the diagnosis of EBV-associated LPD, although the aggressive course precluded the histopathologic diagnosis. Unrelated CB cells mismatched at 1 HLA locus were infused after patient conditioning with 900 mg/m2 etoposide, 2 g/m2 cytarabine, 16 mg/kg busulfan, and 200 mg/kg cyclophosphamide. Complete chimeric status was obtained on day 19 posttransplantation. Drug fever and acute graft-versus-host disease of the skin (grade II) were the major complications. A transient increase of EBV DNA 1 year after CBT indicated a primary EBV infection of the donor cells. The patient is alive with no evidence of disease 27 months after CBT. There has been no previous report of successful CBT for EBV-related LPD/lymphoma. CBT can be a curative treatment for the disease, even if no viral memory has been set in the stem cell source.
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Affiliation(s)
- Taikai Toubo
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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