EBV Related B Cell Lymphoproliferative Disease after T Depleted Mismatched Bone Marrow Transplantation

Abstract

Bone marrow transplantation (BMT) can be life saving for patients with otherwise fatal malignant and non-malignant diseases. Since the majority of people lack an HLA identical sibling much effort has gone into the use of partially mismatched donors. The major obstacles in mismatched BMT have been graft rejection and severe graft vs. host disease. At the University of Minnesota we have experienced an additional complication of mismatched BMT; B cell lymphproliferative disease (BLPD) associated with EBV. Five of twenty one (24$) recipients of T depleted mismatched BMT developed fatal overwhelming lymphoproliferative processes in comparison to the very low incidence in matched T depleted (0/25) or matched non-depleted (1/>500) setting. It is clear that this subgroup of BMT recipients is at an alarmingly increased risk of developing this complication.