[The course of epstein-barr virus and cytomegalovirus infection in children with acute leukaemia during chemotherapy].
OBJECTIVE
To assess the course of EBV and CMV infection among children with acute leukaemia during chemotherapy with the aim to establish an efficient monitoring strategy.


METHODS
We have analyzed 28 children with acute leukaemia (age: 4 months-16 years) treated in the Department of Paediatric Haematology and Oncology, Medical University of Warsaw between 2004 and 2007 according to accepted chemotherapy protocols. In serum samples the presence of antibodies for viral capsid antigen, for nuclear and early antigen of EBV were tested by ELISA. Antibodies against CMV were tested by MEIA. Serum, blood, bone marrow samples, were tested for EBV by nested-PCR and serum samples for CMV by QT-PCR.


RESULTS
We observed primary EBV infection in 4 patients, reactivation in 11, persistent infection in one, previously undergone infection in 12 and primary CMV infection in 1 child, reactivation in 2. Nine patients were seronegative for CMV. One fatal outcome was caused by CMV pneumonitis, confirmed by ELISA test (IgM+; IgG+). Increased total bilirubin, aminotransferases and alkaline phosphatase levels correlated with CMV DNA level in one blood sample. During the chemotherapy no EBV antibodies were detected in 6 patients despite positive results in earlier tests. Viral DNA was detected in one blood sample and in 2 patients it was detected in bone marrow.


CONCLUSIONS
In children with leukaemia during chemotherapy primary and reactivation EBV infection occurred more often than CMV infection. Part of patients with EBV or CMV infections were seronegative during chemotherapy. Molecular biology should be the method of choice for confirmation and monitoring viral infection during intensive chemotherapy for these patients.
Mucha
Maja
M
Katedra i Klinika Pediatrii, Hematologii i Onkologii AM w Warszawie, ul. Marszałkowska 24, 00-576 Warszawa, Poland. maja2107@o2.pl
Pawelec
Katarzyna
K
Matysiak
Michał
M
D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D018450:Disease Progression; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000453:epidemiology*
D000970:Antineoplastic Agents