6533b7d1fe1ef96bd125d6f0

RESEARCH PRODUCT

Epstein-Barr virus DNA load kinetics analysis in allogeneic hematopoietic stem cell transplant recipients: Is it of any clinical usefulness?

David NavarroEstela GiménezMaría José TerolJuan Carlos Hernandez BoludaJosé Luis PiñanaVíctor VinuesaCarlos SolanoEva M. MateoAlberto TalayaEliseo AlbertAriadna Pérez

subject

Male0301 basic medicineEpstein-Barr Virus InfectionsHerpesvirus 4 HumanDna loadmedicine.medical_treatmentLymphoproliferative disordersHematopoietic stem cell transplantationPolymerase Chain ReactionVirus03 medical and health sciencesAntineoplastic Agents Immunological0302 clinical medicinehemic and lymphatic diseasesVirologyClinical informationHumansTransplantation HomologousMedicineRetrospective Studiesbusiness.industryHematopoietic Stem Cell TransplantationEpstein-Barr virus DNAvirus diseasesViral Loadmedicine.diseaseTransplant RecipientsKinetics030104 developmental biologyInfectious DiseasesDNA ViralImmunologyFemaleRituximabReagent Kits DiagnosticAllogeneic hematopoietic stem cell transplantRituximabbusiness030215 immunologymedicine.drug

description

Abstract Background There is a lack of clinical information regarding the usefulness of plasma Epstein-Barr virus (EBV) DNA load kinetics analyses in the management of EBV infections in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Namely, it remains unknown whether this type of analysis can help physicians to anticipate the development of high-level EBV DNAemia episodes requiring rituximab treatment or predict the risk of recurrent EBV DNAemia or post-transplant lymphoproliferative disorders (PTLDs). Study design Unicentric, retrospective, observational study including 142 consecutive patients undergoing T-cell replete allo-HSCT. The plasma EBV DNA load was monitored on a weekly basis using the artus® EBV PCR kit. Results Fifty-five of the 142 patients (38.7%) developed at least one episode of EBV DNAemia; 13 of the 55 initial EBV DNAemia episodes (23.6%) were preemptively treated with rituximab, 7 patients had a recurrent episode of EBV DNAemia, and biopsy-proven PTLDs were diagnosed in 4 patients. The initial plasma EBV DNA load was not significantly different (P = 0.269) in episodes of self-resolving EBV DNAemia, those requiring rituximab treatment, or those leading to PTLDs. The plasma EBV DNA load doubling times were similar across all the groups (P = 0.799), and the EBV DNA-load half-life was not associated with the occurrence of recurrent EBV DNAemia (P = 0.550). Conclusion Plasma EBV DNA-load kinetics analyses are unlikely to be useful in predicting the occurrence of high-level EBV DNAemia, PTLD, or recurrent EBV DNAemia.

https://doi.org/10.1016/j.jcv.2017.10.016