Resolution of EBV⁺ CNS lymphoma with appearance of CSF EBV‐specific T cells

Abstract

Current knowledge of Epstein-Barr virus (EBV)-specific T-cell responses in the cerebrospinal fluid (CSF) of patients with EBV-related lymphoproliferative disease (EBV-LPD) in the central nervous system (CNS) is very limited. Here, we present two recipients of hematopoietic stem cell transplants with EBV-LPD in the CNS. EBV-specific CD8(+) T lymphocytes were detected in CSF and peripheral blood using major histocompatibility complex (MHC) class I multimers loaded with EBV-derived peptides. The appearance of EBV-specific CD8(+) T cells in CSF and blood correlated with neurological improvement and disappearance of EBV-LPD. These observations suggest a role for EBV-specific CD8(+) T cells in the control of EBV-LPD in the CNS.

Isolated cerebral manifestation of Epstein–Barr virus‐associated post‐transplant lymphoproliferative disorder after allogeneic hematopoietic stem cell transplantation: a case of clinical and diagnostic challenges

“…As reported recently in 2 patients with CNS–PTLD, the appearance of virus‐specific CD8+ T cells correlates with clinical and neurological improvement, highlighting the importance of T‐cell immunity in PTLD (36). We performed unselected DLI from the EBV‐seropositive donor to support lymphoma regression via EBV‐specific T cells, a procedure successfully used in the context of PTLD after allogeneic HSCT (27, 37).…”

Improvement of Paraneoplastic Limbic Encephalitis after Systemic Treatment with Rituximab in a Patient with B-Cell Chronic Lymphocytic Leukemia

“…In an uncontrolled trial, a total of nine patients with paraneoplastic syndromes, including one patient with PLE, were treated with Rituximab [13]. Three patients showed a response to the treatment with improvements of neurological syndromes.…”

Post-transplant lymphoproliferative disorder of the cauda equina in a kidney transplant recipient

“…It is common in patients after pancreas and kidney transplantation [13]. There are only three case reports of PTLD developing at the T5 level in the spinal cord after kidney transplantation [15], one report of PTLD developing in the brain and cauda equina 1 year after hematopoietic stem cell transplantation [16] and one report of PTLD developing in the ventral aspect of the spinal cord 61 days after hematopoietic stem cell transplantation [17]. According to another report, PTLD developed in the spinal cord in 10% of 33 cases, but no further details were provided [12].…”