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27 May 2014 : Case report  

Utility of quantitative EBV DNA measurements in cerebrospinal fluid for diagnosis and monitoring of treatment of central nervous system EBV-associated post-transplant lymphoproliferative disorder after allogenic hematopoietic stem cell transplantation

Joanna BocianBCDEF, Danuta Januszkiewicz-LewandowskaADE

DOI: 10.12659/AOT.890372

Ann Transplant 2014; 19:253-256

Abstract

BACKGROUND: Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorder (PTLD) after hematopoietic stem cell transplantation (HSCT) is a rare but life- threatening condition. Despite routine EBV DNA-emia monitoring in blood, central nervous system involvement of the disease is still associated with diagnostic difficulties and poor outcome.

CASE REPORT: We describe a 17-year-old female patient with severe aplastic anemia who developed central nervous system EBV-associated PTLD after matched unrelated allo- HSCT. EBV DNA concentration in cerebrospinal fluid was initially tested due to central nervous system-related symptoms. The sample was found to be highly EBV DNA-positive. Using quantitative real-time polymerase chain reaction (PCR) measurements, therapy efficiency was monitored until complete remission of the EBV-associated PTLD.

CONCLUSIONS: The case report illustrates the high utility of quantitative real-time PCR EBV measurements in cerebrospinal fluid for rapid diagnosis and therapy monitoring of central nervous system EBV-associated PTLDs after allo-HSCT.

Keywords: real- time PCR, Epstein- Barr virus, allogenic hematopoietic stem cell transplantation, Cerebrospinal Fluid, post- transplant lymphoproliferative disorder

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358