Tanaka Tomoyuki, Takizawa Jun, Miyakoshi Shukuko, Kozakai Takashi, Fuse Kyoko, Shibasaki Yasuhiko, Moriyama Masato, Ohshima Koichi, Toba Ken, Furukawa Tatsuo, Sone Hirohito, Masuko Masayoshi
Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Japan.
Intern Med. 2014;53(18):2115-9. doi: 10.2169/internalmedicine.53.2384. Epub 2014 Sep 15.
We herein report the case of a 22-year-old woman with severe aplastic anemia who underwent allogeneic hematopoietic stem cell transplantation (HSCT). After HSCT, the Epstein-Barr virus (EBV)-DNA load in the peripheral blood gradually increased, and the patient presented with a fever and lymphadenopathy on day 56 post-HSCT. Although we administered rituximab, her clinical condition worsened. After rituximab treatment, CD8 T-cells emerged and became dominant in the peripheral blood, some of which were positive on an EBV-specific tetramer analysis. However, an open biopsy of the lymphadenopathy lesions revealed the CD8 T-cells to be infected with EBV, exhibiting proliferation with oligoclonality. The patient ultimately died of multiple organ failure on day 99 post-HSCT.
我们在此报告一例22岁的严重再生障碍性贫血女性患者，其接受了异基因造血干细胞移植（HSCT）。HSCT后，外周血中EB病毒（EBV）-DNA载量逐渐增加，患者在HSCT后第56天出现发热和淋巴结病。尽管我们给予了利妥昔单抗治疗，但她的临床状况仍恶化。利妥昔单抗治疗后，CD8 T细胞在外周血中出现并占主导地位，其中一些在EBV特异性四聚体分析中呈阳性。然而，对淋巴结病病变进行的开放性活检显示CD8 T细胞感染了EBV，表现为寡克隆性增殖。该患者最终在HSCT后第99天死于多器官衰竭。
