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Epstein-Barr Virus Infection and Posttransplant Lymphoproliferative Disease

  • Benjamin E. Gewurz
  • Elizabeth Moulton
  • Amy Bessnow
  • David M. WeinstockEmail author
  • Sheila Bond
Chapter

Abstract

Epstein-Barr virus (EBV) is an oncogenic herpesvirus with a worldwide seroprevalence of >90%. Like all members of the herpesvirus family, EBV establishes infection that persists for the lifetime of the host. In most healthy patients, both primary EBV infection and lifelong latent infection are benign. However, in an immunocompromised host, such as a transplant recipient, either primary infection or reactivation of latent infection can lead to severe disease. The most significant EBV-associated illness that occurs following solid-organ or hematopoietic stem cell transplantation is posttransplant lymphoproliferative disease (PTLD). In this chapter, we provide an overview of the virus, its life cycle, host immune control, diagnostic testing, and efforts at vaccine development. Particular focus is given to the clinical features, diagnosis, and management of EBV-associated PTLD.

Keywords

Epstein-Barr virus Herpesvirus Posttransplant lymphoproliferative disease (PTLD) Acyclovir Ganciclovir Rituximab Adoptive immunotherapy 

Abbreviation

AIM

Acute infectious mononucleosis

AP-1

Activating protein-1

ATG

Antithymocyte globulin

BCR

B-cell receptor

ChIP-Seq

Chromatin immunoprecipitation-sequencing

CIITA

Class II, major histocompatibility complex, transactivator

CNS

Central nervous system

CR

Complete response

CT

Computed tomography

CTL

Cytotoxic lymphocytes

D

Diffuse

DLBCL

Diffuse large B-cell lymphoma

DLI

Donor lymphocyte infusion

DNA

Deoxyribonucleic acid

EA

Early antigen

EBER

Epstein-Barr virus-encoded ribonucleic acid

EBNA

Epstein-Barr virus nuclear antigen

EBV

Epstein-Barr virus

ELISA

Enzyme-linked immunosorbent assays

GC

Germinal center

gp350

Glycoprotein 350

GVHD

Graft versus host disease

HDACi

Histone deacetylation inhibitors

HIV

Human immunodeficiency virus

HL

Hodgkin lymphoma

HLA

Human leukocyte antigen

HSCT

Hematopoietic stem cell transplantation

IC50

Half maximal inhibitory concentration

IF

Immunofluorescence

IL-10

Interleukin 10

LCL

Lymphoblastoid cell line

LMP

Latent membrane protein

MHC

Major histocompatibility complex

miRNA

MicroRNA

NIH

National Institutes of Health

NK

Natural killer

NPC

Nasopharyngeal carcinoma

ORR

Objective response rate

PCR

Polymerase chain reaction

PET

Positron emission tomography

PR

Partial response

PTLD

Posttransplant lymphoproliferative disease

R

Restricted

RI

Reduction of immunosuppression

RNA

Ribonucleic acid

RR

Response rate

RS

Reed-Sternberg

SOT

Solid-organ transplantation

TAP

Transporter associated with antigen processing

UCBT

Umbilical cord blood transplantation

VCA

Viral capsid antigen

VZV

Varicella zoster virus

WHO

World Health Organization

XLP

X-linked lymphoproliferative disease

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Benjamin E. Gewurz
    • 1
  • Elizabeth Moulton
    • 2
  • Amy Bessnow
    • 3
  • David M. Weinstock
    • 3
    Email author
  • Sheila Bond
    • 1
  1. 1.Brigham and Women’s Hospital, Division of Infectious DiseasesBostonUSA
  2. 2.Baylor College of Medicine, Department of Pediatrics, Infectious DiseasesHoustonUSA
  3. 3.Dana-Farber Cancer Institute, Division of Medical OncologyBostonUSA

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