Detection of EBV DNA in the cord blood donor for a patient developing Epstein-Barr virus-associated lymphoproliferative disorder following mismatchedunrelated umbilical cord blood transplantation

Epstein-Barr virus-associated post-transplant lymphoproliferative disorder (PTLD) has been well described as a complication following allogeneic stem cell transplantation but has only recently been reported following umbilica l cord blood (UCB) transplant, We report the case of a child transplanted w ith unrelated mismatched UCB for juvenile chronic myelogenous leukemia (JCM L) who developed EBV-associated PTLD, which was confirmed pathologically, 1 39 days following stem cell infusion. There was no clinical response to red uction of immune suppression, high-dose acyclovir, or alpha interferon, The patient died 160 days after transplantation. EBV was detected by polymeras e chain reaction in the cord blood unit used for transplantation. This case demonstrates that EBV-associated PTLD can occur following mismatched unrel ated UCB transplant and may be related to transmission of EBV infection by donor lymphocytes.