Lazarovits A I, Tibbles L A, Grant D R, Ghent C N, Wall W J, White M J, Joncas J H
University Hospital, London, Ontario.
Clin Invest Med. 1994 Dec;17(6):621-5.
Epstein-Barr virus-induced lymphoproliferative syndrome (EBV-LPS) is associated with OKT3 therapy in transplant patients. Response to chemotherapy or radiation is generally poor, while polyclonal EBV-LPS has had favorable responses to therapy with CD21 and CD24 monoclonal antibodies. Oligoclonal disease has not been previously reported to respond to therapy with CD21 and CD24. We report a 27-y old woman who developed a monoclonal EBV-LPS (confirmed by southern analysis of tumour for EBV DNA) after 180 mg of OKT3 for a multivisceral transplant. The patient achieved clinical remission for more than 2 months, but later died from cytomegalovirus pneumonia. Levels of CD21 and CD24 were > 2000 ng/ml during therapy and no human anti-mouse antibodies were formed. Peripheral blood B cells were cleared during therapy. We conclude that CD21 and CD24 monoclonal antibodies may be of value in the therapy of oigoclonal EBV-LPS, and merit further study.
爱泼斯坦-巴尔病毒诱导的淋巴增殖综合征（EBV-LPS）与移植患者的OKT3治疗相关。化疗或放疗的反应通常较差，而多克隆EBV-LPS对CD21和CD24单克隆抗体治疗有良好反应。此前尚未报道寡克隆疾病对CD21和CD24治疗有反应。我们报告一名27岁女性，在接受180毫克OKT3进行多脏器移植后发生了单克隆EBV-LPS（通过对肿瘤进行EBV DNA的Southern分析证实）。该患者实现了超过2个月的临床缓解，但后来死于巨细胞病毒肺炎。治疗期间CD21和CD24水平>2000纳克/毫升，且未形成人抗鼠抗体。治疗期间外周血B细胞被清除。我们得出结论，CD21和CD24单克隆抗体可能对寡克隆EBV-LPS治疗有价值，值得进一步研究。
