Patient, graft, and EBV-PTLD characteristics
| . | Patient #1 . | Patient #2 . |
|---|---|---|
| Age/sex | 32 y/male | 10 y/female |
| Diagnosis | Primary refractory peripheral T-cell NHL | AML |
| Remission status | 1st partial remission | 2nd complete remission |
| Conditioning | Cyclo 120 mg/kg | Busulfan 0.8 mg/kg × 16 |
| Flu 75 mg/m2 | Cyclo 200 mg/kg | |
| TBI 1375 cGy | Equine ATG 90 mg/kg | |
| Immune suppression | Cyclosporine-A Mycophenolate mofetil | Tacrolimus Prednisone (1 mg/kg) |
| Infused TNC dose | Double unit graft: | Single unit graft: 4.9 × 107/kg |
| Engrafting unit*: 2.4 × 107/kg | ||
| Non-engrafting unit: 2.5 × 107/kg | ||
| HLA-A,-B antigen, DRB1 allele | Engrafting unit*: 5/6 HLA Allele match; make donor | 4/6 HLA Allele match; male donor |
| Match | Non-engrafting unit: 5/6 HLA Allele match; donor | |
| GVHD/ GVHD therapy | Grade II skin and gut/corticosteroids | Grade II gut/corticosteroids |
| PTLD onset | +253 days | +244 days |
| Organ involvement | Tonsil, upper and lower GI tract, lungs | Brain, lung, upper and lower GI tract |
| Pathology | Monomorphic DLBCL; EBV (EBER-ISH)+, CD20−, CD79a+; Donor origin by qPCR for informative STR of tumor specimen | Monomorphic DLBCL; EBV (EBER-ISH)+, CD20+; Donor origin by FISH for the Y chromosome |
| . | Patient #1 . | Patient #2 . |
|---|---|---|
| Age/sex | 32 y/male | 10 y/female |
| Diagnosis | Primary refractory peripheral T-cell NHL | AML |
| Remission status | 1st partial remission | 2nd complete remission |
| Conditioning | Cyclo 120 mg/kg | Busulfan 0.8 mg/kg × 16 |
| Flu 75 mg/m2 | Cyclo 200 mg/kg | |
| TBI 1375 cGy | Equine ATG 90 mg/kg | |
| Immune suppression | Cyclosporine-A Mycophenolate mofetil | Tacrolimus Prednisone (1 mg/kg) |
| Infused TNC dose | Double unit graft: | Single unit graft: 4.9 × 107/kg |
| Engrafting unit*: 2.4 × 107/kg | ||
| Non-engrafting unit: 2.5 × 107/kg | ||
| HLA-A,-B antigen, DRB1 allele | Engrafting unit*: 5/6 HLA Allele match; make donor | 4/6 HLA Allele match; male donor |
| Match | Non-engrafting unit: 5/6 HLA Allele match; donor | |
| GVHD/ GVHD therapy | Grade II skin and gut/corticosteroids | Grade II gut/corticosteroids |
| PTLD onset | +253 days | +244 days |
| Organ involvement | Tonsil, upper and lower GI tract, lungs | Brain, lung, upper and lower GI tract |
| Pathology | Monomorphic DLBCL; EBV (EBER-ISH)+, CD20−, CD79a+; Donor origin by qPCR for informative STR of tumor specimen | Monomorphic DLBCL; EBV (EBER-ISH)+, CD20+; Donor origin by FISH for the Y chromosome |
NHL indicates non-Hodgkin lymphoma; AML, acute myelogenous leukemia; cyclo, cyclophosphamide; flu, fludarabine; TBI, total-body irradiation; ATG, anti-thymocyte globulin; TNC, total nucleated cell dose; HLA, human leukocyte antigen; GVHD, graft-versus-host disease; PTLD, posttransplantation lymphoproliferative disease; DLBCL, diffuse large B-cell lymphoma; EBV, Epstein-Barr virus, EBER-ISH; EBV encoded RNA in-situ hybridization; qPCR, quantitative polymerase chain reaction; STR, short tandem repeats; and FISH, fluorescent in situ hybridization.
Patient was 100% donor in bone marrow and blood with the engrafting unit and at no time was the nonengrafting unit detected.