Hodgkin lymphoma in a renal transplant recipient associated with low peripheral blood Epstein-Barr virus genome copies

Posttransplant lymphoproliferative disorders are often accompanied by >500 Epstein-Barr virus (EBV) genome copies/10(5) lymphocytes, and they occur sh ortly after transplantation. Hodgkin lymphoma occurs rarely after transplan tation, appearing a mean of 4.2 years posttransplant, and although Hodgkin lymphoma has strong associations with EBV, no quantitative analysis of peri pheral blood EBV genome copies has been reported. A mixed cellularity Hodgk in lymphoma developed in a 17-year-old boy 4 years after a renal transplant . Serial EBV genome copy numbers from blood by competitive polymerase chain reaction had been obtained to assess for lymphoproliferative disease. Epst ein-Barr virus genome copy numbers peaked at 500 copies/10(5) lymphocytes 8 months prior to Hodgkin lymphoma diagnosis but fell to 8 copies/10(5) lymp hocytes at diagnosis. Reliance on EBV levels greater than 500 copies may re sult in delay of biopsy and diagnosis of Hodgkin disease in the posttranspl ant setting.