Identification of Peripheral Blood Cells Infected with Epstein–Barr Virus: A Practical Method for Choosing the Initial Treatment for Post-Transplantation Lymphoproliferative Disease

Abstract

Using rituximab for treating post-transplantation lymphoproliferative disease (PTLD) is generally decided according to the clinical presentation and pathology. We report a PTLD case treated with rituximab on the basis of the detected peripheral blood cells infected with Epstein–Barr virus. A 2-year-old boy diagnosed with PTLD 3 months after heart transplantation manifested fever, respiratory symptoms, and diarrhea. Identification of peripheral blood cells infected with the virus showed that such cells were of B cell origin, indicating that the patient may benefit from rituximab treatment. This result enabled us to use rituximab before the biopsy results came out. Therefore, identification of peripheral blood cells infected with Epstein–Barr virus may help quickly decide whether to use rituximab in patients with PTLD whose biopsy results may be delayed.