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Viral Infection

Viral-load and B-lymphocyte monitoring of EBV reactivation after allogeneic hemopoietic SCT in children

Bone Marrow Transplantation volume 45, pages 1052–1055 (2010)Cite this article

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.

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Authors and Affiliations

  1. Hematology-Oncology Department, Hemopoietic Stem cell Transplant Unit, G Gaslini Children's Research Institute, Genova, Italy

    M Faraci, G Morreale, E Lanino, D Cuzzubbo, S Giardino, F Scuderi, S Dallorso & P Terranova

  2. Hematology-Oncology Department, Infectious Diseases Unit, G Gaslini Children's Research Institute, Genova, Italy

    I Caviglia, C Moroni & E Castagnola

  3. Central Laboratory Analysis, Experimental-Clinical Medicine Laboratory, G Gaslini Children's Research Institute, Genova, Italy

    E Di Marco & C Cirillo

Authors
  1. M Faraci
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  2. I Caviglia
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  3. G Morreale
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  4. E Lanino
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  5. D Cuzzubbo
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  6. S Giardino
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  7. E Di Marco
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  8. C Cirillo
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  9. F Scuderi
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  10. S Dallorso
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  11. P Terranova
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  12. C Moroni
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  13. E Castagnola
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Correspondence to M Faraci.

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Faraci, M., Caviglia, I., Morreale, G. et al. Viral-load and B-lymphocyte monitoring of EBV reactivation after allogeneic hemopoietic SCT in children. Bone Marrow Transplant 45, 1052–1055 (2010). https://doi.org/10.1038/bmt.2009.302

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