Sequential monitoring of plasma EBV-DNA level in a patient with EBV-positive Hodgkin lymphoma

• Published in: Rinshō ketsueki Vol. 53; no. 1; p. 87
• Main Authors: Uchida, Emi, Honma, Riko, Igarashi, Aiko, Kurata, Morito, Imadome, Ken-Ichi, Omoto, Eijiro, Miura, Osamu, Arai, Ayako
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-01-2012
• Subjects: Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers - blood; Bleomycin - administration & dosage; Dacarbazine - administration & dosage; DNA, Viral - blood; Doxorubicin - administration & dosage; Epstein-Barr Virus Infections - diagnosis; Female; Fever - etiology; Herpesvirus 4, Human - genetics; Hodgkin Disease - diagnosis; Hodgkin Disease - drug therapy; Hodgkin Disease - virology; Humans; Lymphatic Diseases - etiology; Middle Aged; Vinblastine - administration & dosage; Viral Load
• ISSN: 0485-1439
• DOI: 10.11406/rinketsu.53.87

A 58-year-old woman was admitted to our hospital because of fever, systemic lymphadenopathy with abnormal Epstein-Barr virus (EBV) antibody titers, and a high EBV-DNA load in the serum. She had been diagnosed as possibly having chronic active EBV infection (CAEBV) during a previous hospitalization. The EBV-DNA load of the plasma (pEBV-DNA), examined at our hospital, was elevated to 1.8×10(4) copies/ml, whereas that of the peripheral blood mononuclear cells was 3.4×10(1) copies/μg DNA, which was not clearly elevated, unlike in cases with CAEBV. Biopsy of the cervical lymph node was performed and the diagnosis of mixed cellularity classical Hodgkin lymphoma, Stage4B was made. Hodgkin cells were positive for EBV. COPP therapy was started and pEBV-DNA decreased drastically. The treatment was followed by ABVD therapy and pEBV-DNA turned negative after one course of ABVD therapy. She achieved complete response after 4 courses of the treatment. Reports from abroad indicate that pEBV-DNA parallels the disease state of EBV-positive Hodgkin lymphoma. Our results were consistent with these reports, and demonstrated that, in a Japanese patient, EBV-DNA load and its localization in the peripheral blood fractions could be useful tools for diagnosis as well as evaluating the disease status.