NK-cell repertoire is feasible for diagnosing Epstein-Barr virus-infected NK-cell lymphoproliferative disease and evaluating the treatment effect

Am J Hematol. 2006 Aug;81(8):576-81. doi: 10.1002/ajh.20659.

Abstract

Epstein-Barr virus (EBV) occasionally infects T and NK cells and causes EBV-infected T/NK-cell lymphoproliferative disease (LPD), which comprises chronic active EBV infection, EBV-associated hemophagocytic syndrome, mosquito allergy, hydroa vacciniforme, aggressive NK-cell leukemia, and NK/T-cell lymphoma. The diagnosis is proven by the monoclonal proliferation of EBV-infected T or NK cells, which is a time-consuming and complicated method. T-cell monoclonality is helpful for the screening of EBV-infected T-cell LPD in patients with EBV-genome burden and is easily shown with T-cell-receptor rearrangement or the T-cell repertoire, whereas NK-cell monoclonality is difficult to prove due to its lacking such rearranged receptors. We investigated a set of killer immunoglobulin-like receptors (KIRs) and also CD94-NKG2 heterodimers on NK cells, namely the NK-cell repertoire. Skewed repertoires were seen in all patients with EBV-infected NK-cell LPD, but not in any patients with EBV-infected T-cell LPD and were restored only after successful treatment. The normal KIR repertoire is variable for each individual and it seems difficult to detect minimal residual EBV-infected lymphocytes. However, the NK-cell repertoire is feasible for identifying EBV-infected NK-cell LPD and evaluating the treatment effect.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers / analysis
  • Biomarkers / metabolism
  • Child
  • Child, Preschool
  • Disease Progression
  • Drug Evaluation
  • Epstein-Barr Virus Infections / immunology*
  • Female
  • Humans
  • Infant
  • Killer Cells, Natural / immunology*
  • Killer Cells, Natural / virology*
  • Lymphoproliferative Disorders / diagnosis
  • Lymphoproliferative Disorders / immunology*
  • Lymphoproliferative Disorders / therapy
  • Male
  • Recurrence
  • Stem Cell Transplantation*
  • Transplantation, Homologous
  • Treatment Outcome

Substances

  • Biomarkers