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Viral-load and B-lymphocyte monitoring of EBV reactivation after allogeneic hemopoietic SCT in children.
- Source :
-
Bone Marrow Transplantation . Jun2010, Vol. 45 Issue 6, p1052-1055. 4p. 2 Charts. - Publication Year :
- 2010
-
Abstract
- EBV-associated post transplant lymphoproliferative disease (EBV-PTLD) is a life-threatening complication that may occur after hemopoietic SCT. We prospectively screened 80 children on a weekly basis using nested quantitative PCR to evaluate EBV genome copies. EBV viral load <1000 copies per 105 PBMC was observed in 63% of transplants, whereas it was between 1000 and 9999 copies per 105 PBMC in 13%, and between 10 000 and 19 999 in 10%, with no significant increase in percentage of CD20+ lymphocytes. Viral load reached 20 000 copies per 105 PBMC in 14% of patients, and rituximab was administered to 75% of them. None of the patients except one developed a lymphoproliferative disease. Our study found that only 13% of unrelated donor HSCT recipients had a very high risk of EBV-PTLD defined as 20 000 geq per 105 PBMC associated with an increase in CD20+ lymphocyte. We suggest that rituximab could be administered in the presence of very high levels of EBV-DNA viral load or in the presence of mid levels of EBV-DNA viral load associated with an increase in the percentage of CD20+ lymphocytes. Through this approach, we significantly reduced the number of patients treated with rituximab, and consequently the acute and chronic adverse events related to this treatment. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 02683369
- Volume :
- 45
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Bone Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 51313439
- Full Text :
- https://doi.org/10.1038/bmt.2009.302