Lymphoproliferative disorders involving Epstein-Barr virus after hemopoietic stem cell transplantation

Curr Opin Oncol. 1999 Mar;11(2):96-101. doi: 10.1097/00001622-199903000-00004.


Lymphoproliferative disorders involving uncontrolled expansion of donor-derived B cells infected with Epstein-Barr virus (EBV) are a significant problem after hemopoietic stem cell transplantation. Risk factors, which include T cell depletion, major histocompatibility complex mismatch, and intensity of immunosuppression illustrate the importance of T cell immune surveillance. Recent studies have identified viral and host factors that affect the T-cell response to EBV. Monitoring EBV load in the blood by polymerase chain reaction allows early identification of high-risk patients and early institution of therapy. Adoptive immunotherapy approaches using donor T cells have proven effective and EBV-specific cytotoxic T lymphocytes have also been used successfully for prophylaxis. The simplest way of preventing EBV lymphoproliferation, however, may be to deplete B cells from the donor marrow prior to infusion to prevent the transmission of EBV-infected B cells.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • B-Lymphocytes / immunology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Lymphoproliferative Disorders / etiology*
  • Lymphoproliferative Disorders / therapy
  • Lymphoproliferative Disorders / virology*
  • Risk Factors
  • T-Lymphocytes / immunology