IMMUNOBLASTIC LYMPHOMA OF DONOR ORIGIN IN THE ALLOGRAFT AFTER LUNG TRANSPLANTATION1
1996; Wolters Kluwer; Volume: 61; Issue: 12 Linguagem: Inglês
10.1097/00007890-199606270-00010
ISSN1534-6080
AutoresSteven J. Mentzer, Janina Longtine, Joyce D. Fingeroth, John J. Reilly, Malcolm M. DeCamp, Walter J. O’Donnell, Steven Swanson, Douglas V. Faller, David J. Sugarbaker,
Tópico(s)Cytomegalovirus and herpesvirus research
ResumoPosttransplant lymphoproliferative disorders (PTLD) are EBV-associated lymphoid neoplasms that are caused by the uncontrolled growth of EBV-infected B lymphocytes. The clinical presentation of PTLD can range from benign polygonal lymphoproliferative disorders to aggressive monoclonal immunoblastic lymphomas. In this report, we describe a seronegative lung transplant recipient who developed an immunoblastic lymphoma 4 months after lung transplantation from a seropositive donor. The neoplastic cells expressed B lymphocyte markers (CD19+, CD20+, sIgM+, kappa+) as well as the EBV antigen EBNA-2. A cell line with similar cytologic features spontaneously grew from in vitro cultures of the patient's peripheral blood mononuclear cells. The cell line and the lymphoma were EBV+, expressed a similar spectrum of B cell surface proteins, and had the donor's HLA haplotype. Analysis of immunoglobulin gene rearrangements and viral terminal repeat sequences revealed that the cell line and the tumor represented distinct B cell clones. Cultured peripheral blood mononuclear cells were restimulated in vitro with the EBV transformed cell line and tested for cytolytic activity. The host T cells demonstrated high levels of cytolytic activity against the tumor cell line that was abrogated by the addition of a anti-monomorphic HLA class I monoclonal antibody (mAb) (W6/32). These studies indicate that cells of donor origin can persist in the transplanted organ and may lead to an EBV-associated posttransplant lymphoma.
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