DLI-induced remission in recurrent EBV-associated T/NK-cell lymphoproliferative disease following HSCT: a case report.

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.