Selective outgrowth of a posttransplant B-immunoblastic lymphoma expressing a latent membrane protein-1 deletion variant.

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.

• Authors: G R Kershaw, C Berger, C McQuain, A S al-Homsi, G Pihan, P J Quesenberry, B A Woda, H Knecht
• Journal: Transplantation (Transplantation) Vol. 64 Issue 7 Pg. 1079-81 (Oct 15 1997) ISSN: 0041-1337 [Print] United States
• PMID: 9381534 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• EBV-associated membrane antigen, Epstein-Barr virus
• Immunotoxins
• Viral Matrix Proteins

Topics

• Adult
• Amino Acid Substitution
• Female
• Genetic Variation
• Glomerulonephritis, IGA (surgery)
• Herpesvirus 4, Human (genetics, isolation & purification)
• Humans
• Immunotoxins (therapeutic use)
• Kidney Transplantation
• Living Donors
• Lymphoma, B-Cell (drug therapy, pathology, virology)
• Point Mutation
• Postoperative Complications
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy, pathology, virology)
• Sequence Deletion
• Tumor Virus Infections (drug therapy, pathology)
• Viral Matrix Proteins (genetics)
• Virus Latency