Korean J Hematol.  2007 Jun;42(2):167-171. 10.5045/kjh.2007.42.2.167.

Quantifing the Circulating Epstein-Barr Virus (EBV) DNA to Monitor a Case of Aggressive Natural Killer Cell Leukemia

• Yi SY
• Kim HS
• Jun HJ
• Yang JH
• Ko YH
• Ki CS
• Kim WS

• KMID: 2083516
• DOI: http://doi.org/10.5045/kjh.2007.42.2.167

Abstract

Epstein-Barr virus (EBV) infection is associated with various lymphoproliferative diseases, including Hodgkin lymphoma, extranodal NK/T cell lymphoma, aggressive NK cell leukemia, Burkitt lymphoma and post-transplant lymphoproliferative disorder. In the recent studies, the plasma EBV-DNA levels in patients with EBV-associated lymphoproliferative disease appeared to be correlated with the therapeutic response. Aggressive NK cell leukemia (ANKL) is a fatal disease that's characterized by high fever, lymphadenopathy, hepatosplenomegaly and frequent hemophagocytosis. No serological tumor marker for this malignancy has yet been identified for monitoring the disease and predicting the outcome. We experienced a case of aggressive natural killer cell leukemia in a 48-year-old man, and we serially monitored the plasma EBV DNA load by performing real time quantitative PCR assay. Serial measurements of the plasma EBV DNA level during therapy showed a close correlation between the clinical response and the changes in the plasma EBV DNA titers.

Keyword

Aggressive natural killer cell leukemia (ANKL); Epstein Barr virus (EBV); Real time quantitative PCR

MeSH Terms

Burkitt Lymphoma
DNA*
Fever
Herpesvirus 4, Human*
Hodgkin Disease
Humans
Killer Cells, Natural*
Leukemia*
Lymphatic Diseases
Lymphoma
Lymphoproliferative Disorders
Middle Aged
Plasma
Polymerase Chain Reaction
DNA

Figure

• 

  Fig. 1 The bone marrow shows focal infiltration by monotonous neoplastic cells, which are admixed with hemophagocytic histiocytes (arrow) (H&E stain, ×400).

• 

  Fig. 2 (A) The neoplastic cells are positive for CD 56 (arrow) (immunohistochemisty, ×100), (B) In situ hybridization for EBV shows staining of tumor cells (arrows) (EBV-ISH, ×400).

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  Fig. 3 Serial measurements of plasma EBV DNA level during therapy showed a close correlation between EBV-DNA titer and liver function test (total bilirubin, AST, LDH).

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