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A monoclonal immunoblastic sarcoma in donor cells bearing Epstein-Barr
virus genomes following allogeneic marrow grafting for acute lymphoblastic
leukemia
WH Schubach, R Hackman, PE Neiman, G Miller and ED Thomas
A patient undergoing marrow grafting for acute lymphoblastic leukemia from
his partially HLA-mismatched sister displayed a widely disseminated
immunoblastic sarcoma at autopsy. The tumor was monoclonal by
immunoglobulin light-chain staining. Blot hybridization analysis, using a
cloned highly polymorphic locus in human DNA as a probe, showed the tumor
to be of donor-cell origin. Cytogenetic analysis also demonstrated
donor-cell origin. Blot hybridization analysis demonstrated Epstein-Barr
virus (EBV) genomes in the tumor. By contrast, reexamination of material
from a previously reported case of a donor-type relapse showed no evidence
of EBV DNA. In neither case was there evidence of cytomegalovirus DNA. This
study documents the association of EBV with a malignant, monoclonal B-cell
lymphoma arising in a marrow graft recipient. We conclude that DNA
restriction fragment length polymorphisms can be used to prove the origin
(donor or host) of neoplastic relapse following allogeneic marrow grafting.
Further, cell types different from those of the original leukemia may be
involved.
Volume 60,
Issue 1,
pp. 180-187,
07/01/1982
Copyright © 1982 by The American Society of Hematology
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