SUCCESSFUL BONE-MARROW TRANSPLANTATION IN A BOY WITH X-LINKED LYMPHOPROLIFERATIVE SYNDROME AND ACUTE SEVERE INFECTIOUS-MONONUCLEOSIS

We report a 5.9-year-old boy with X-linked lymphoproliferative syndrom e (XLP) who presented with acute severe infectious mononucleosis. Clin ical symptoms rapidly improved after chemotherapy with etoposide. Allo geneic bone marrow transplantation (BMT) was performed after condition ing with etoposide, busulfan and cyclophosphamide. After successful he matopoietic recovery we were able to demonstrate seroconversion from a n impaired antibody response to Epstein-Barr virus (EBV) to a normal a ntibody-producing state in an immunocompetent child. The only post-tra nsplant complication was mild acute graft-versus-host disease (GVHD). Three years after BMT, the boy is healthy and shows no signs of immuno deficiency. This is the first report on successful allogeneic BMT in t he severe course of acute infectious mononucleosis in a patient with X LP. We speculate that the application of etoposide contributed to the positive outcome in this patient.