Utility of quantitative EBV DNA measurements in cerebrospinal fluid for diagnosis and monitoring of treatment of central nervous system EBV-associated post-transplant lymphoproliferative disorder after allogenic hematopoietic stem cell transplantation
Joanna Bocian, Danuta Januszkiewicz-Lewandowska
Department of Medical Diagnostics, Poznań University of Medical Sciences, Poznań, Poland
Ann Transplant 2014; 19:253-256
Available online: 2014-05-27
Epstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disorder (PTLD) after hematopoietic stem cell transplantation (HSCT) is a rare but life- threatening condition. Despite routine EBV DNA-emia monitoring in blood, central nervous system involvement of the disease is still associated with diagnostic difficulties and poor outcome.
Case Report: We describe a 17-year-old female patient with severe aplastic anemia who developed central nervous system EBV-associated PTLD after matched unrelated allo- HSCT. EBV DNA concentration in cerebrospinal fluid was initially tested due to central nervous system-related symptoms. The sample was found to be highly EBV DNA-positive. Using quantitative real-time polymerase chain reaction (PCR) measurements, therapy efficiency was monitored until complete remission of the EBV-associated PTLD.
Conclusions: The case report illustrates the high utility of quantitative real-time PCR EBV measurements in cerebrospinal fluid for rapid diagnosis and therapy monitoring of central nervous system EBV-associated PTLDs after allo-HSCT.
Keywords: real- time PCR, Epstein- Barr virus, allogenic hematopoietic stem cell transplantation, Cerebrospinal Fluid, post- transplant lymphoproliferative disorder