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Updated: May 21, 2025
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Published on: March 30, 2018
DLI-induced remission in recurrent EBV-associated T/NK-cell lymphoproliferative disease following HSCT: a case report
Toru Nagata1, Hirohito Kubota1, Itaru Kato2
1Department of Pediatrics, Kyoto University Hospital, 54 Syogoin Kawaramachi Sakyo-Ku, Kyoto, 606-8507, Japan.
Background:
Epstein-Barr virus (EBV)-associated T/natural killer (NK)-cell lymphoproliferative diseases (T/NK-LPDs) are characterized by clonal proliferation of EBV-infected T or NK cells, and the only curative treatment for progressive T/NK-LPDs is allogeneic hematopoietic stem cell transplantation (HSCT). There are limited reports concerning optimal management strategies for disease relapse after HSCT in patients with EBV-associated T/NK-LPDs.
Case Presentation:
A 2-year-old girl was diagnosed with severe mosquito bite allergy, a cutaneous form of EBV-associated T/NK-LPD. Following HSCT from her human leukocyte antigen-matched sister, complete donor-type chimerism was achieved and whole blood EBV-DNA load became undetectable. However, the whole blood EBV-DNA load became elevated again and donor type chimerism decreased. Donor lymphocyte infusion (DLI) was performed to control the disease relapse. A complete virological response and complete donor-type chimerism were attained after four doses of DLI. No adverse effects were observed during the treatment course.
Conclusions:
This case highlights the potential of DLI as an alternative therapeutic approach to re-transplantation for recurrent EBV-associated T/NK-LPDs.
