Epstein-Barr virus-associated lymphoproliferative disease after a cord blood transplant for Diamond-Blackfan anemia

A 7-year-old boy with Diamond-Blackfan anemia (DBA) developed lymphoprolife rative disease (LPD) after a cord blood transplant (CBT), 3.1 x 10(7)/kg mo nonuclear cells from an HLA one-locus mismatched CB were transplanted after conditioning with total body irradiation (8 Gy), cyclophosphamide (200 mg/ kg) and antithymocyte globulin (10 mg/kg), Complete engraftment occurred on day 33 post transplant, Despite the resolution of grade II graft-versus-ho st disease (GVHD), he died of lymphoma on day 130 post transplant. The tumo r was of donor origin, indicating clonal proliferation of Epstein-Barr viru s (EBV)infected B cells, This is the first report of EBV-LPD after CBT, Pos t-transplant LPD can be a serious EBV-associated complication of CB grafts.