Fatal exacerbations of chronic active Epstein-Barr virus infection subsequent to cytotoxic chemotherapy

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  • SUMA Sakurako
    Department of Hematology, University of Tsukuba Hospital
  • KURITA Naoki
    Department of Hematology, University of Tsukuba Hospital Department of Hematology, Faculty of Medicine, University of Tsukuba
  • BABA Naoko
    Department of Hematology, University of Tsukuba Hospital
  • ISHITSUKA Kantaro
    Department of Hematology, University of Tsukuba Hospital
  • SUKEGAWA Shinichiro
    Department of Hematology, University of Tsukuba Hospital
  • MAKISHIMA Kenichi
    Department of Hematology, University of Tsukuba Hospital
  • KIYOKI Yusuke
    Department of Hematology, University of Tsukuba Hospital
  • MARUYAMA Yumiko
    Department of Hematology, University of Tsukuba Hospital
  • KATO Takayasu
    Department of Hematology, University of Tsukuba Hospital Department of Hematology, Faculty of Medicine, University of Tsukuba
  • YOKOYAMA Yasuhisa
    Department of Hematology, University of Tsukuba Hospital Department of Hematology, Faculty of Medicine, University of Tsukuba
  • SAKATA-YANAGIMOTO Mamiko
    Department of Hematology, University of Tsukuba Hospital Department of Hematology, Faculty of Medicine, University of Tsukuba
  • OBARA Naoshi
    Department of Hematology, University of Tsukuba Hospital Department of Hematology, Faculty of Medicine, University of Tsukuba
  • HASEGAWA Yuichi
    Department of Hematology, University of Tsukuba Hospital Department of Hematology, Faculty of Medicine, University of Tsukuba
  • CHIBA Shigeru
    Department of Hematology, University of Tsukuba Hospital Department of Hematology, Faculty of Medicine, University of Tsukuba

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Other Title
  • 抗腫瘍薬投与直後に急激に症状が悪化し致死的となった慢性活動性EBウイルス感染症
  • 症例報告 抗腫瘍薬投与直後に急激に症状が悪化し致死的となった慢性活動性EBウイルス感染症
  • ショウレイ ホウコク コウシュヨウヤク トウヨ チョクゴ ニ キュウゲキ ニ ショウジョウ ガ アッカ シ チシテキ ト ナッタ マンセイ カツドウセイ EB ウイルス カンセンショウ

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Abstract

<p>Chronic active Epstein-Barr virus infection (CAEBV) is critical owing to lethal complications such as hemophagocytic lymphohistiocytosis (HLH), multiple organ failure, and malignant lymphoma. Here we present two cases of CAEBV who developed rapid and life-threatening disease progression after cytotoxic chemotherapy. Case 1: In a 34-year-old male, CAEBV recurred after 4-month remission obtained by initial therapy with etoposide, cyclosporine, and prednisolone. Accordingly, cord blood transplantation was planned. A day after administering high-dose melphalan as the conditioning, he developed respiratory failure, pancytopenia, and hyperferritinemia. He died 3 days later. Case 2: A 53-year-old female attained remission after initial therapy for CAEBV. After 1 month, she relapsed, and high-dose cytarabine (HDAC) was administered. A day after HDAC administration, she suddenly developed respiratory failure, which was followed by multiple organ failure. She died 3 days later. Thus, planned strategy for prompt allogeneic hematopoietic stem cell transplantation is necessary to prevent disease progression and control cytokinemia before cytotoxic chemotherapy for CAEBV.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 60 (4), 286-290, 2019

    The Japanese Society of Hematology

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