Early intervention in post-transplant lymphoproliferative disorders based on Epstein-Barr viral load.

Using a real-time quantitative PCR assay, we identified two patients with EBV-related lymphoproliferative disorders at a very early stage. Both had received an unmanipulated bone marrow transplant with anti-thymocyte globulin for conditioning. To estimate virus-specific immunity, the frequencies of EBV-specific CD8+ T cells were measured using an enzyme-linked immunospot assay. The frequencies of EBV-specific CD8+ T cells of the two were 3.2 and 7.7%, respectively, which had possibly expanded in vivo. After withdrawing the immunosuppressive agents or administering donor lymphocytes transfusion, their symptoms regressed in parallel with the viral load.