Posttransplantation B lymphoblastic leukemia with Burkitt-like features

Background. Posttransplantation Epstein-Barr virus-associated lymphoprolife rative disease (PTLPD) occurs as a spectrum of disease ranging from benign, polyclonal, localized lymphoid hyperplasia to malignant, monoclonal, disse minated lymphoma, sometimes involving the bone marrow. To our knowledge, PT LPD has not been previously reported to present as acute lymphoblastic leuk emia, Methods. We report the case of a boy who developed PTLPD in the form of acu te lymphoblastic leukemia 6 years after cardiac transplantation. He had gre ater than 90% bone marrow invasion by Epstein-Barr virus-positive B lymphob lasts with Burkitt-like features and a t(8;14) translocation, Results, He was successfully treated with combination chemotherapy but unfo rtunately died, 6 months after completing treatment, from ischemic heart di sease. Conclusions. B lymphoblastic leukemia may occur as a manifestation of PTLPD and should be included in the classification of these diseases. Bone marro w examination should be an essential part of the investigation of patients suspected of having PTLPD.