Associations of serum EBV DNA and gammopathy with post-transplant lymphoproliferative disease.
BACKGROUND
Post-transplant lymphoproliferative disease (PTLD) is a life-threatening complication of immunosuppression following transplantation. Epstein-Barr virus (EBV) and gammopathy in serum are associated with PTLD, but these two parameters have not been evaluated in parallel for their association with PTLD.


METHODS
We evaluated the incidence of EBV load positivity, gammopathy, and protein expression in sera from all PTLD patients diagnosed at our hospital during the past seven yr. Results were compared with those of a control group including matched transplanted patients who did not develop PTLD.


RESULTS
Seven of 10 PTLD patients presented EBV(+) PTLD, for which five patients had detectable serum EBV DNA levels compared with none of 38 controls (RR between two groups =121, p < 0.0001). Five out of 10 patients had gammopathy at PTLD diagnosis compared with 5/38 controls (RR between two groups = 6.6, p = 0.022). Additionally, protein serum analysis by high-resolution two-dimensional gel electrophoresis and image examination failed to evidence specific abnormality in patients with PTLD compared with controls.


CONCLUSIONS
Our results confirm an association between EBV in sera and gammopathy with PTLD, and highlight the high specificity of the former analysis. Whether a combination of both analyses will improve the clinical detection of PTLD remains to be evaluated in a larger prospective cohort study.
Rosselet
Anne
A
Service d'Hématologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Vu
Dinh-Hao
DH
Meylan
Pascal
P
Chaubert
Audrey S Baur
AS
Schapira
Marc
M
Pascual
Manuel
M
Aubert
Vincent
V
Tissot
Jean-Daniel
JD
Duchosal
Michel A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000097:blood* / Q000235:genetics; D015180:Electrophoresis, Gel, Two-Dimensional; D020031:Epstein-Barr Virus Infections / Q000821:virology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D017403:In Situ Hybridization; D015994:Incidence; D016030:Kidney Transplantation; D008232:Lymphoproliferative Disorders / Q000097:blood* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000150:complications*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014184:Transplantation, Homologous; D019562:Viral Load; D055815:Young Adult
D004279:DNA, Viral; D007166:Immunosuppressive Agents