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Stem cells cure chronic EBV

globalpilot

Senior Member
Messages
626
Location
Ontario
http://bloodjournal.hematologylibrary.org/content/117/22/5835.long

Chronic active EBV disease (CAEBV) is a lymphoproliferative disorder characterized by markedly elevated levels of antibody to EBV or EBV DNA in the blood and EBV RNA or protein in lymphocytes in tissues. We present our experience with CAEBV during the last 28 years, including the first 8 cases treated with hematopoietic stem cell transplantation in the United States. Most cases of CAEBV have been reported from Japan. Unlike CAEBV in Japan, where EBV is nearly always found in T or natural killer (NK) cells in tissues, EBV was usually detected in B cells in tissues from our patients. Most patients presented with lymphadenopathy and splenomegaly; fever, hepatitis, and pancytopenia were common. Most patients died of infection or progressive lymphoproliferation. Unlike cases reported from Japan, our patients often showed a progressive loss of B cells and hypogammaglobulinemia. Although patients with CAEBV from Japan have normal or increased numbers of NK cells, many of our patients had reduced NK-cell numbers. Although immunosuppressive agents, rituximab, autologous cytotoxic T cells, or cytotoxic chemotherapy often resulted in short-term remissions, they were not curative. Hematopoietic stem cell transplantation was often curative for CAEBV, even in patients with active lymphoproliferative disease that was unresponsive to chemotherapy. These studies are registered at http://www.clinicaltrials.gov as NCT00032513 for CAEBV, NCT00062868 and NCT00058812 for EBV-specific T-cell studies, and NCT00578539 for the hematopoietic stem cell transplantation protocol
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,089
Location
australia (brisbane)
Interesting thanks for the post, i have lymphocytosis from ebv/cmv, which i guess is a lymphoproliferation disorder. My nk numbers are normal but function is very crappy. Maybe the Japenese patients had bad nk function even though numbers were normal. Do u know if nk function test was done on the Japanese??

cheers!!!
 

globalpilot

Senior Member
Messages
626
Location
Ontario
Hi, I don't know but I haven't read the whole paper yet. I'll report back when I have and know more.

Interesting thanks for the post, i have lymphocytosis from ebv/cmv, which i guess is a lymphoproliferation disorder. My nk numbers are normal but function is very crappy. Maybe the Japenese patients had bad nk function even though numbers were normal. Do u know if nk function test was done on the Japanese??

cheers!!!
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
I'm confused, under the methods it says:

Controls for cytokine and antibody measurements were persons with chronic inflammatory disorders and with chronic fatigue syndrome on protocols approved by the Institutional Review Board at NIH.

But under the results, in figure 4 it says:

CTRL indicates healthy EBV-seropositive control patients

?
 

globalpilot

Senior Member
Messages
626
Location
Ontario
It looks like the Japanese with CAEBV do have poor NK function

"Reduced NK-cell activity has been reported in 8 of 9 patients with CAEBV from Japan25 and in 2 patients from Canada.10"

That;s 2 of 2 patients in the Canadian reference.

What I'm not understanding and maybe someone can enlighten me. They are discussing a lymhoproliferative disorder. However, in the report they discuss DECREASED amounts of lymphocytes.
"A striking feature of our patients was a progressive loss of B cells and hypogammaglobulinemia, even in the absence of rituximab therapy. Forty-two percent developed hypogammaglobulinemia, 43% had low numbers of CD19 cells in the absence of rituximab therapy, 31% had low NK cells, 38% had low CD4 cells, and 44% had low CD8 cells (Table 4). Patients with B-cell CAEBV more often had CD19 cell numbers less than normal (56% of B-cell CAEBV patients vs 0% of T-cell CAEBV patients), and the mean percent of CD19 cells in patients with B-cell CAEBV (5.6%) was lower than that for patients with T-cell CAEBV (14.5%). "

Also giving hemopoteic cells would also result in more lymphocytes.



Interesting thanks for the post, i have lymphocytosis from ebv/cmv, which i guess is a lymphoproliferation disorder. My nk numbers are normal but function is very crappy. Maybe the Japenese patients had bad nk function even though numbers were normal. Do u know if nk function test was done on the Japanese??

cheers!!!