Diagnosis and treatment of posttransplantation lymphoproliferative disease after hematopoietic stem cell transplantation

Biol Blood Marrow Transplant. 2002;8(1):1-8. doi: 10.1053/bbmt.2002.v8.pm11846351.


Uncontrolled expansion of donor-derived Epstein-Barr virus (EBV)-infected B cells has become a significant problem in recipients of allogeneic hematopoietic stem cell transplantations. Major risk factors for the early development of posttransplantation lymphoproliferative disease include the use of unrelated or HLA-mismatched related donors, selective T-cell depletion of donor marrow, and the use of antithymocyte globulin or monoclonal anti-T-cell antibodies for the prophylaxis and treatment of acute graft-versus-host disease. Over the past few years, the administration of in vitro-generated EBV-specific cytotoxic T cells or anti-B-cell monoclonal antibodies has provided effective options for the prophylaxis or treatment of posttransplantation lymphoproliferative disease. Advances in quantitative polymerase chain reaction-based assays allow both the precise measurement of EBV load in peripheral blood samples and the identification of high-risk patients for early initiation of therapy. A major remaining challenge is to assess the significance of an elevated EBV load posttransplantation and to determine the indications for preemptive treatment.

Publication types

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

MeSH terms

  • Antibodies, Neoplasm / therapeutic use
  • Epstein-Barr Virus Infections / diagnosis
  • Epstein-Barr Virus Infections / etiology
  • Epstein-Barr Virus Infections / prevention & control
  • Humans
  • Immunotherapy, Adoptive
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / etiology
  • Lymphoproliferative Disorders / prevention & control*
  • Stem Cell Transplantation / adverse effects*
  • Transplantation Immunology


  • Antibodies, Neoplasm