Lymphomatoid granulomatosis following autologous stem cell transplantation.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Lymphomatoid granulomatosis following autologous stem cell transplantation.

Bone Marrow Transplant. 1999 Jan;23(1):79-81. Unique Identifier : AIDSLINE MED/99154658
Fassas A; Jagannath S; Desikan KR; Shah HR; Shaver R; Waldron J; Munshi NC; Barlogie B; Tricot G; University of Arkansas for Medical Sciences and Arkansas Cancer; Research Center, Little Rock, USA.

Abstract: Lymphomatoid granulomatosis (LYG) is a rare angio-destructive lymphoproliferative disorder (LPD) of uncertain etiology, with prominent pulmonary involvement. Recent studies indicate that LYG is an Epstein-Barr virus (EBV)-associated B cell LPD with large numbers of background reactive T lymphocytes (T cell-rich B cell lymphoma). Although the disease frequently, but not exclusively, occurs in various immunodeficiency states, it has not been reported in association with the transient immunosuppression following autologous bone marrow/peripheral stem cell transplantation (ABM/PSCT). We describe a patient who developed lymphomatoid granulomatosis of the lung approximately 2 weeks after high-dose chemotherapy and autologous peripheral stem cell transplantation for multiple myeloma. Although molecular studies showed no evidence of EBV genome in the biopsy material, the serologic profile with high IgM titers was suggestive of primary EBV infection. Complete radiologic remission occurred following reconstitution of the patient's immune response after a 2-week course of ganciclovir treatment. Despite the apparently low frequency of LPD (both LYG and EBV-associated post-transplant lymphoma) in the ABMT setting, we believe that it should be considered in the differential diagnosis of patients whose clinical course following ABMT is complicated by fevers, in the absence of an identifiable infectious process.

Keywords: JOURNAL ARTICLE Antineoplastic Agents, Combined/*ADVERSE EFFECTS/THERAPEUTIC USE Case Report Child Combined Modality Therapy/ADVERSE EFFECTS Female Hematopoietic Stem Cell Transplantation/*ADVERSE EFFECTS Herpesviridae Infections/ETIOLOGY Herpesvirus 4, Human/ISOLATION & PURIF Human Lung Diseases/*ETIOLOGY/PHYSIOPATHOLOGY Lymphomatoid Granulomatosis/*ETIOLOGY/PHYSIOPATHOLOGY Middle Age Multiple Myeloma/*THERAPY Transplantation, Autologous Tumor Virus Infections/ETIOLOGY
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A9980930

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