Epstein-barr virus infection following bone-marrow transplantation

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Abstract
A 12‐year‐old patient with acute lymphoblastic leukemia received a bone‐marrow transplant (BMT) from a matched sibling donor. Nine weeks prior to transplant the donor experienced Epstein‐Barr virus (EBV)‐induced infectious mononucleosis. The bone‐marrow recipient was EBV‐negative at the time of transplant; however, 4 weeks post transplant the recipient developed clinical symptoms of graft‐versus‐host disease (GVHD) coincident with serological evidence of acute EBV infection. In addition, a lymphoblastoid cell line positive for Epstein‐Barr nuclear antigen was established from a bone‐marrow sample obtained at the onset of symptoms compatible with GVHD. Sera obtained from the recipient over the ensuing 2 months showed the appearance of antibodies to specific EBV antigens consistent with a primary immune response to EBV infection. This association of acute EBV infection with symptoms of GVHD in a BMT recipient suggests a need for further investigation of the epidemiology of EBV infections in human bone‐marrow transplantation and the relationship between EBV infection and GVHD.