Treatment of chronic active EBV infection in children and management of post-transplant complications: a case report

Chronic active Epstein-Barr virus (CAEBV) infection is a rare and fatal disease caused by persistent EBV infection. During the progressive phase of CAEBV, children are highly susceptible to life-threatening complications such as hemophagocytic syndrome, multiple organ failure (particularly liver and kidney failure), coagulation disorders, and hemangiomas, resulting in a high mortality rate. Traditional treatments such as immunotherapy or chemotherapy are limited in effectiveness, and children may succumb to the disease within a few years. Currently, allogeneic therapy (hematopoietic stem cell transplantation [HSCT]) is the only curative measure for this disease. However, this procedure may lead to a series of complications that threaten the lives of the transplanted children. Therefore, mastering the correct management approach and exploring new preventive and therapeutic measures are crucial. This paper reports a case of a child with CAEBV who developed complications after allogeneic HSCT. Through the comprehensive use of immunomodulators and personalized treatment strategies, patient's conditions was improved significantly.