How I treat EBV lymphoproliferation

Blood. 2009 Nov 5;114(19):4002-8. doi: 10.1182/blood-2009-07-143545. Epub 2009 Sep 1.


Epstein-Barr virus (EBV)-associated B-cell lymphoproliferation is a life-threatening complication after hematopoietic stem cell or solid organ transplantation resulting from outgrowth of EBV-infected B cells that would normally be controlled by EBV-cytotoxic T cells. During the past decade, early detection strategies, such as serial measurement of EBV-DNA load in peripheral blood samples, have helped to identify high-risk patients and to diagnose early lymphoproliferation. Treatment options include manipulation of the balance between outgrowing EBV-infected B cells and the EBV cytotoxic T lymphocyte response and targeting the B cells with monoclonal antibodies or chemotherapy. Major challenges remain for defining indications for preemptive therapies and integrating novel and conventional therapies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Antiviral Agents / therapeutic use
  • B-Lymphocytes / immunology
  • B-Lymphocytes / virology
  • Epstein-Barr Virus Infections / diagnosis
  • Epstein-Barr Virus Infections / etiology
  • Epstein-Barr Virus Infections / therapy*
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Herpesvirus 4, Human / immunology
  • Herpesvirus 4, Human / pathogenicity
  • Humans
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / etiology
  • Lymphoproliferative Disorders / therapy*
  • Rituximab
  • T-Lymphocytes, Cytotoxic / immunology
  • T-Lymphocytes, Cytotoxic / transplantation
  • Tissue Donors
  • Transplants / adverse effects


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antiviral Agents
  • Rituximab