BACKGROUND: We wanted to determine the clinical significance and predictability of Epstein-Barr virus (EBV) infections among a large cohort of recipients of allogeneic, unselected stem cell transplants. METHODS: During 1988-1999, a total of 5479 consecutive serum samples obtained during 406 transplantations performed in Helsinki, Finland, were retrospectively analyzed by quantitative polymerase chain reaction for the presence of EBV DNA. RESULTS: Overall, EBV DNA was noted in at least 1 serum sample for 57 patients (14.0%), of whom 22 (5.4%) were found to have progressively increasing and ultimately high (>50,000 copies/mL) EBV DNA levels (median level, 179,000 copies/mL). In addition, 16 patients (4.0%) had low EBV DNA levels (median level, 3260 copies/mL) in isolated sera before death. Among the transplant recipients who survived, transient EBV DNAemia (median level, 3110 copies/mL), which apparently corresponded to asymptomatic EBV infection, was noted in 19 patients (4.7%). CONCLUSIONS: Low-level EBV DNA positivity in serum occurs relatively frequently after stem cell transplantation and may subside without specific treatment. However, high EBV DNA levels (i.e., >50,000 copies/mL) are strong predictors for the development of posttransplantation lymphoproliferative disease, are not spontaneously reversible, and should be treated immediately. If the EBV DNA level is >or=50,000 copies/mL, the patient can be classified as having life-threatening EBV infection.
BACKGROUND: We wanted to determine the clinical significance and predictability of Epstein-Barr virus (EBV) infections among a large cohort of recipients of allogeneic, unselected stem cell transplants. METHODS: During 1988-1999, a total of 5479 consecutive serum samples obtained during 406 transplantations performed in Helsinki, Finland, were retrospectively analyzed by quantitative polymerase chain reaction for the presence of EBV DNA. RESULTS: Overall, EBV DNA was noted in at least 1 serum sample for 57 patients (14.0%), of whom 22 (5.4%) were found to have progressively increasing and ultimately high (>50,000 copies/mL) EBV DNA levels (median level, 179,000 copies/mL). In addition, 16 patients (4.0%) had low EBV DNA levels (median level, 3260 copies/mL) in isolated sera before death. Among the transplant recipients who survived, transient EBV DNAemia (median level, 3110 copies/mL), which apparently corresponded to asymptomatic EBV infection, was noted in 19 patients (4.7%). CONCLUSIONS: Low-level EBV DNA positivity in serum occurs relatively frequently after stem cell transplantation and may subside without specific treatment. However, high EBV DNA levels (i.e., >50,000 copies/mL) are strong predictors for the development of posttransplantation lymphoproliferative disease, are not spontaneously reversible, and should be treated immediately. If the EBV DNA level is >or=50,000 copies/mL, the patient can be classified as having life-threatening EBV infection.
Authors: Anneclaire J De Roos; Otoniel Martínez-Maza; Keith R Jerome; Dana K Mirick; Kenneth J Kopecky; Margaret M Madeleine; Larry Magpantay; Kerstin L Edlefsen; Andrea Z Lacroix Journal: Cancer Epidemiol Biomarkers Prev Date: 2013-07-24 Impact factor: 4.254
Authors: Carol J Holman; Amy B Karger; Beth D Mullan; Richard C Brundage; Henry H Balfour Journal: Clin Transplant Date: 2012-03-04 Impact factor: 2.863
Authors: Luciana Cristina Fagundes Gequelin; Irina N Riediger; Sueli M Nakatani; Alexander W Biondo; Carmem M Bonfim Journal: Rev Bras Hematol Hemoter Date: 2011
Authors: Junji Sashihara; Yo Hoshino; J Jason Bowman; Tammy Krogmann; Peter D Burbelo; V McNeil Coffield; Kurt Kamrud; Jeffrey I Cohen Journal: PLoS Pathog Date: 2011-10-20 Impact factor: 6.823
Authors: Jin-Hua Liang; Rui Gao; Yi Xia; Robert Peter Gale; Rui-Ze Chen; Yu-Qiong Yang; Li Wang; Xiao-Yan Qu; Hai-Rong Qiu; Lei Cao; Min Hong; Rong Wang; Yan Wang; Lei Fan; Yao-Yu Chen; Zhi-Bin Hu; Jian-Yong Li; Wei Xu Journal: Oncotarget Date: 2016-01-12