Virus-specific cytotoxic T lymphocytes as prophylaxis for Epstein-Barr virus lymphoproliferative disease in pediatric bone marrow transplant recipients

Abstract

Epstein-Barr virus lymphoproliferative disease (EBV LPD) is a well-recognized, life-threatening complication of bone marrow transplantation (BMT). The incidence of EBV LPD is increasing as more transplants are performed from mismatched and unrelated donors. Significant strides have been made in the diagnosis, prevention, and treatment of EBV LPD in marrow transplant recipients. Immunovirological assays can provide early identification of patients at risk for developing EBV LPD. Prophylaxis and treatment by the adoptive transfer of EBV-specific T cells and the subsequent long-term restoration of immunity against EBV-associated lymphoproliferation have provided positive outcomes in the management of this uniformly fatal complication of BMT. The purpose of this article is to provide a review of EBV LPD and to present a newly developed strategy for EBV LPD prophylaxis in pediatric BMT recipients.