Epstein-Barr virus DNA in cerebrospinal fluid from patients with AIDS-related primary lymphoma of the central nervous system

Cinque, Paola; Brytting, Maria; Wahrén, Britta; Linde, Annika; Castagna, Antonella; Lazzarin, Adriano; Vago, Luca; Parravicini, Carlo; Zanchetta, Nadia; Monforte, Antonella d’Arminio

doi:10.1016/0140-6736(93)92814-a

Cited by 301 publications

(137 citation statements)

References 11 publications

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“…The diagnosis of EBV-BPLD was further supported by positive PCR (DNA from PB, BM, lymph node) using different sets of primers for Epstein-Barr encoded RNA (EBER) and Epstein-Barr nuclear antigen (EBNA). 11,12 At autopsy, there was no evidence of CLL and all histological findings from enlarged lymph nodes were in agreement with the diagnosis of polymorphic type of EBV-LPD.…”

supporting

confidence: 55%

“…These cases demonstrate the significant level of immune suppression after our treatment protocol and thus confirm the potential of combination therapy containing purine analogues to reactivate a latent EBV infection, as Lazzarino et al 8 convincingly showed and others described in case reports. 10,12 The addition of another agent with additional immunosuppressive effect such as, for example, cyclophosphamide in our study or corticoids may increase this risk. Our series of patients suggests the possible causative role of the increased exposure to the Cy besides FAMP administration.…”

mentioning

confidence: 98%

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Epstein–Barr virus-associated B-cell lymphoproliferative disorder in CLL patients after treatment with fludarabine and cyclophosphamide followed by high-dose chemotherapy with autologous stem cell transplantation

Jindra

Koza

Boudová

et al. 2003

Bone Marrow Transplant

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supporting

confidence: 55%

mentioning

confidence: 98%

Epstein–Barr virus-associated B-cell lymphoproliferative disorder in CLL patients after treatment with fludarabine and cyclophosphamide followed by high-dose chemotherapy with autologous stem cell transplantation

Jindra

Koza

Boudová

et al. 2003

Bone Marrow Transplant

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“…On day +218, EBV DNA within peripheral blood nucleated cells (PBNC) was detected by PCR ( Figure 3). 10 On day +226, she received 10 6 CD3 + T cells/kg of body weight from her donor. Fourteen days after the first DLT, EBV DNA within PBNC could no longer be detected by PCR.…”

mentioning

confidence: 99%

Donor lymphocyte transfusion for the treatment of Epstein–Barr virus-associated lymphoproliferative disorder of the brain

Nagafuji

Eto

Hayashi

et al. 1998

Bone Marrow Transplant

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Summary:EBV-associated lymphoproliferative disorder (LPD) is a rare but serious complication in marrow transplant recipients. A 31-year-old Japanese woman in the second chronic phase of CML received an allogeneic BMT from her HLA 2-locus-incompatible 62-year-old father. Around day +200, she developed EBV-LPD of the right parieto-temporal lobe which caused slowly progressive left hemiparesis. Two courses of donor lymphocyte transfusions (DLT) of 10 6 CD3 + T cells/kg of body weight failed to suppress her central nervous system (CNS) EBV-LPD. The patient died of recurrent blastic crisis of CML. This case suggests that DLT may be ineffective for the treatment of CNS EBV-LPD. Keywords: Epstein-Barr virus-associated lymphoproliferative disorder; donor lymphocyte transfusion; central nervous system EBV-associated lymphoproliferative disorder (LPD) is a rare but serious complication in marrow transplant recipients. 1,2 Although there are reports of successful treatment of polyclonal or oligoclonal proliferations with agents such as interferon-␣ and intravenous ␥-globulin, high-dose acyclovir, and anti-B-cell MoAb, 3-5 monoclonal disease has remained refractory to treatment in marrow transplant recipients.Recently, donor lymphocyte transfusions (DLT) have been shown to be an effective treatment for EBV-LPD. 6,7 We report the case of a Japanese woman, who developed EBV-LPD of the right cerebrum following allogeneic BMT and who was then treated with DLT. Case reportA 31 year-old Japanese woman was admitted to our hospital for the treatment of myeloid blastic crisis (BC) of CML Correspondence: Dr K Nagafuji, Department of Hematology, Hara Sanshin General Hospital, 1-8 Taihaku-machi, Hakata-ku, Fukuoka 812, Japan Received 4 August 1997; accepted 22 December 1997 in July 1996. She entered the second chronic phase after treatment with vincristine and prednisolone. The patient had no HLA-identical siblings, nor were there any HLAidentical unrelated donors in the Japan Marrow Donor Program. Because of the poor prognosis in BC, we decided to perform a BMT using her HLA 2-locus-incompatible 62-year-old father as donor. The donor was seropositive for human T cell leukemia virus type 1 (HTLV-1), while the recepient was seronegative. 8 Both the recipient and the donor were seropositive for EBV (VCA IgG ×40 VCA IgM Ͻ×10 EBNA ×10, VBCA IgG ×640 VCA IgM Ͻ×10 EBNA ×10, respectively).The pre-transplant conditioning consisted of BU 4 mg/kg orally in divided doses daily on days −8 to −5, and CY 50 mg/kg i.v. daily on days −4 to −2. Because of ABO major incompatibility, bone marrow mononuclear cells isolated by density-gradient centrifugation (1.8 × 10 8 /kg of body weight) were given. Tacrolimus (FK506; Fujisawa, Osaka, Japan) in combination with MTX was used for GVHD prophylaxis. Grade II GVHD of the skin developed on day +11 but this responded well to high-dose methylprednisolone therapy. Granulocytes exceeded 0.5 × 10 9 /l on day +16, and platelets exceeded 50 × 10 9 /l on day +26. Prolonged administration of immunosuppressive agents wa...

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“…Marcadores de clonogenicidade (como as cadeias kappa e lambda) e a reação em cadeia por polimerase (PCR) podem ser de ajuda para distinguir a proliferação dos linfócitos de uma pleocitose reativa. Cinque et al 4 sugerem que a técnica de PCR para a detecção do DNA do vírus de Epstein-Barr pode ser útil como marcador tumoral, relatando sensibilidade de 100% e especifídade de 98,5% nos linfomas primários do SNC-AIDS 4 Tal diagnóstico deve ser prudentemente acompanhado da investigação de outras infecções que comprometem a medula espinhal 2,5 -10 -18,20,27 -29,30 -32 .…”

Section: Discussionunclassified

Mielite transversa como manifestação clínica inicial de linfoma não Hodgkin disseminado e mielopatia vacuolar associada ao HIV: relato de caso

Moura¹,

Silvestre²,

Araújo³

et al. 1996

Arq. Neuro-Psiquiatr.

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RESUMO -Linfomas não Hodgkin de alto grau são comumente relatados em pacientes com a síndrome da imunodeficiência adquirida (AIDS). Comprometendo com grande freqüência o sistema nervoso central, particularmente as leptomeninges e os hemisférios cerebrais. O acometimento epidural é pouco freqüente, variando de 3,5% a 8,3% de acordo com os registros da literatura. Os autores relatam o caso de um paciente de 27 anos de idade com AIDS, cuja manifestação clínica inicial da doença linfomatosa disseminada foi a mielite transversa associada à mielopatia vacuolar. Destaca-se a importância do diagnóstico diferencial precoce das mielopatias na AIDS, em virtude da alta malignidade da neoplasia e da evolução extremamente rápida nesses pacientes. PALAVRAS-CHAVE: mielite transversa, linfoma não Hodgkin, mielopatia vacuolar, AIDS.Transverse myelitis as initial symptom of disseminated non-Hodgkin lymphoma and HIV-associated vacuolar myelopathy: case report ABSTRACT -Non-Hodgkin lymphoma is frequently seen in AIDS patients usually affecting the central nervous system (CNS), especially the leptomeninges and the cerebral hemispheres. The epidural involvement is rarely described, ranging from 3.5% to 8.3% among the CNS sites. The authors present a case of disseminated non Hodgkin lymphoma associated to vacuolar myelopathy in a 27 years-old male patient with AIDS emphasizing the importance of this differential diagnosis in the myelopathies of AIDS.KEY WORDS: acute transverse myelitis, non-Hodgkin lymphoma, vacuolar myelopathy, AIDS.O comprometimento crônico da medula espinhal mais freqüente na síndrome da imunodeficiência adquirida (AIDS) é a mielopatia vacuolar, diferentemente registrado entre cerca de 30 e 90% dos pacientes com acometimento do sistema nervoso pelo HIV (vírus da imunodeficiência humana) 13 -24 . Os vacúolos que definem a patologia são caracterizados por alargamento dos espaços interlamelares e periaxonais, que geralmente contêm macrófagos. Topograficamente, as lesões se concentram nos funículos laterais e posteriores da medula espinhal e regionalmente, com maior freqüência, no segmento torácico 7 . A correlação entre a presença do HIV e a mielopatia tem sido

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Epstein-Barr virus DNA in cerebrospinal fluid from patients with AIDS-related primary lymphoma of the central nervous system

Cited by 301 publications

References 11 publications

Epstein–Barr virus-associated B-cell lymphoproliferative disorder in CLL patients after treatment with fludarabine and cyclophosphamide followed by high-dose chemotherapy with autologous stem cell transplantation

Epstein–Barr virus-associated B-cell lymphoproliferative disorder in CLL patients after treatment with fludarabine and cyclophosphamide followed by high-dose chemotherapy with autologous stem cell transplantation

Donor lymphocyte transfusion for the treatment of Epstein–Barr virus-associated lymphoproliferative disorder of the brain

Mielite transversa como manifestação clínica inicial de linfoma não Hodgkin disseminado e mielopatia vacuolar associada ao HIV: relato de caso

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