Chronic active Epstein-Barr virus infection treated with PEG-aspargase: A case report

doi:10.12998/wjcc.v9.i26.7845

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Sep 16, 2021; 9(26): 7845-7849
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7845

Chronic active Epstein-Barr virus infection treated with PEG-aspargase: A case report

De-Li Song, Jing-Shi Wang, Lei-Lei Chen, Zhao Wang

De-Li Song, Jing-Shi Wang, Lei-Lei Chen, Zhao Wang, Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Author contributions: Song DL and Chen LL took care of the patient; Song DL wrote this article; Wang JS and Wang Z guided article writing; all authors have read and approved the final version for submission.

Supported by National Natural Science Foundation of China, No. 81871633; Beijing Natural Science Foundation, No. 7181003; and Beijing Municipal Administration of Hospitals’ Ascent Plan, No. DFL20180101.

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Zhao Wang, MD, Professor, Department of Hematology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing 100050, China. wangzhao@ccmu.edu.cn

Received: March 29, 2021
Peer-review started: March 29, 2021
First decision: April 28, 2021
Revised: May 8, 2021
Accepted: August 13, 2021
Article in press: August 13, 2021
Published online: September 16, 2021
Processing time: 165 Days and 2.6 Hours

Abstract

BACKGROUND

Chronic active Epstein-Barr virus infection (EBV) is a systemic EBV-positive lymphoproliferative disease, which may lead to fatal illness. There is currently no standard treatment regimen for chronic active EBV (CAEBV), and hematopoietic stem cell transplantation is the only effective treatment. We here report a CAEBV patient treated with PEG-aspargase, who achieved negative EBV-DNA.

CASE SUMMARY

A 33-year-old female Chinese patient who had fever for approximately 3 mo was admitted to our hospital in December 2017. EBV-DNA was positive with a high copy number. She was diagnosed with chronic active EB virus infection. PEG-aspargase was administered at a dose of 1500 U/m²at a 14-d interval, resulting in eradication of EBV for more than 6 mo. The effect of PEG-aspargase in this patient was excellent.

CONCLUSION

A chemotherapy regimen containing PEG-aspargase for CAEBV may be further considered.

Keywords: Chronic active Epstein-Barr virus infection; PEG-aspargase; Chemotherapy; L-asparaginase; Case report

Core Tip: Chronic active Epstein-Barr virus (EBV) infection may lead to fatal diseases, including EBV-positive lymphoproliferative disorders, lymphomas, and hemophagocytic lymphohistiocytosis. We present a chronic active EBV (CAEBV) patient who was treated with PEG-aspargase and achieved decreased load of EBV-DNA. PEG-aspargase requires further investigation as a chemotherapy drug for CAEBV to reduce the load of EBV-DNA.