Gr. Kershaw et al., SELECTIVE OUTGROWTH OF A POSTTRANSPLANT B-IMMUNOBLASTIC LYMPHOMA EXPRESSING A LATENT MEMBRANE PROTEIN-1 DELETION VARIANT, Transplantation, 64(7), 1997, pp. 1079-1081
Background. Posttransplant lymphoproliferative disorders are generally
associated with Epstein-Barr virus (EBV) and are of B cell origin. We
report the case of a B-immunoblastic lymphoma that developed in a pre
transplantation EBV-seronegative woman 4 months after kidney transplan
t from her HLA-haploidentical brother. The patient successfully underw
ent immunotoxin therapy for lymphoma and has been in remission for 36
months. Methods. Latent EBV genomes were identified by polymerase chai
n reaction, and the purified amplification products were directly sequ
enced with [S-35]dATP. Results. Molecular analysis of the latent membr
ane protein (LMP)1 oncogene of EBV, which was expressed in most tumor
cells, revealed a 30-base pair deletion. No wild-type LMP1 sequences w
ere found. Analysis of peripheral blood mononuclear cells from the EBV
-seropositive donor showed the presence of both the LMP1 deletion vari
ant and the wild-type sequence. The LMP1 deletion variant and the wild
-type sequence were also identified within peripheral blood mononuclea
r cells of the EBV-seroconverted kidney recipient 20 months after lymp
homa therapy. Conclusion. This pattern is consistent with a natural gr
owth advantage of B cells expressing the LMP1 deletion variant in the
immunocompromised host.