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Viral Infections

A prospective study of Epstein–Barr virus load in 85 hematopoietic stem cell transplants

Bone Marrow Transplantation volume 29, pages 21–28 (2002)Cite this article

Abstract

EBV viral load (EBV-VL) in PBMC was prospectively determined by semi-quantitative PCR in 85 stem cell transplants (40 genoidentical, 45 non-genoidentical) in order to characterize the kinetics of EBV-VL and to assess the ability of this measure to predict the development of EBV-induced lymphoproliferative disease (EBV-LPD). PCR was performed prior to and after transplantation. An EBV-VL >300 copies/μg DNA was chosen as the threshold for risk of developing an EBV-LPD. Two hundred and fifty-eight EBV-VL measures were evaluable. Five patients (5.9%) developed an EBV-LPD. All had an elevated EBV DNA peak level before EBV-LPD. Fifteen out of 80 recipients (18.7%) without EBV-LPD had EBV levels over 300 copies/μg DNA at least once during the follow-up. Overall, the manifestation of at least one EBV-VL over 300 copies/μg DNA during the entire follow-up demonstrated a sensitivity, specificity, positive and negative predictive value for the diagnosis of EBV-LPD of 100%, 81%, 25% and 100%, respectively. In patients without EBV-LPD, HLA incompatibility, grade ⩾II acute GVHD and use of an unmanipulated graft were significantly associated with an EBV-VL >300 copies/μg DNA. This strategy appears sensitive for the diagnosis of EBV-LPD but its positive predictive value has to be improved in order to guide pre-emptive therapy.

Bone Marrow Transplantation (2002) 29, 21–28. doi:10.1038/sj.bmt.1703331

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Acknowledgements

This work was supported by grant from the Association pour la Recherche contre le Cancer (ARC), Villejuif, France

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Authors and Affiliations

  1. Unité de transplantation médullaire, Médecine Infantile II, Hôpital d'enfants, Nancy, France

    A Sirvent-von Bueltzingsloewen & P Bordigoni

  2. Laboratoire de virologie, Hôpital A Michallon, Grenoble, France

    P Morand & M Buisson

  3. Immuno-hématologie pédiatrique et transplantation de moelle osseuse, Hôpital Debrousse, Lyon, France

    G Souillet

  4. Service d'hématologie pédiatrique, Hôpital la Timone, Marseille, France

    H Chambost

  5. Centre d'Investigation Clinique, Hôpital A Michallon, Grenoble, France

    JL Bosson

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  1. A Sirvent-von Bueltzingsloewen
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Sirvent-von Bueltzingsloewen, A., Morand, P., Buisson, M. et al. A prospective study of Epstein–Barr virus load in 85 hematopoietic stem cell transplants. Bone Marrow Transplant 29, 21–28 (2002). https://doi.org/10.1038/sj.bmt.1703331

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