1. Selective outgrowth of a posttransplant B-immunoblastic lymphoma expressing a latent membrane protein-1 deletion variant.
- Author
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Kershaw GR, Berger C, McQuain C, al-Homsi AS, Pihan G, Quesenberry PJ, Woda BA, and Knecht H
- Subjects
- Adult, Amino Acid Substitution, Female, Genetic Variation, Glomerulonephritis, IGA surgery, Humans, Immunotoxins therapeutic use, Living Donors, Lymphoma, B-Cell drug therapy, Lymphoma, B-Cell pathology, Point Mutation, Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology, Sequence Deletion, Tumor Virus Infections drug therapy, Virus Latency, Herpesvirus 4, Human genetics, Herpesvirus 4, Human isolation & purification, Kidney Transplantation, Lymphoma, B-Cell virology, Postoperative Complications, Precursor Cell Lymphoblastic Leukemia-Lymphoma virology, Tumor Virus Infections pathology, Viral Matrix Proteins genetics
- Abstract
Background: Posttransplant lymphoproliferative disorders are generally associated with Epstein-Barr virus (EBV) and are of B cell origin. We report the case of a B-immunoblastic lymphoma that developed in a pretransplantation EBV-seronegative woman 4 months after kidney transplant from her HLA-haploidentical brother. The patient successfully underwent immunotoxin therapy for lymphoma and has been in remission for 36 months., Methods: Latent EBV genomes were identified by polymerase chain reaction, and the purified amplification products were directly sequenced with [35S]dATP., Results: Molecular analysis of the latent membrane protein (LMP)1 oncogene of EBV, which was expressed in most tumor cells, revealed a 30-base pair deletion. No wild-type LMP1 sequences were found. Analysis of peripheral blood mononuclear cells from the EBV-seropositive donor showed the presence of both the LMP1 deletion variant and the wild-type sequence. The LMP1 deletion variant and the wild-type sequence were also identified within peripheral blood mononuclear cells of the EBV-seroconverted kidney recipient 20 months after lymphoma therapy., Conclusion: This pattern is consistent with a natural growth advantage of B cells expressing the LMP1 deletion variant in the immunocompromised host.
- Published
- 1997
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