Prospective evaluation of epstein-barr virus reactivation after stem cell transplantation: association with monoclonal gammopathy.
Epstein-Barr Virus (EBV) reactivation and EBV-related post-transplant lymphoproliferative disease (PTLD) have emerged as a severe complication after stem cell transplantation (SCT). We prospectively evaluated 104 consecutive patients receiving SCT either autologous or allogeneic. Fifty-two patients (50%) presented EBV DNA-emia and five of them developed PTLD proven or probable. PTLD rate was 9.6% among patients with EBV DNA-emia. One patient developed PTLD without EBV DNA-emia (0.96%). Overall PTLD incidence was 5.7%. No PTLD developed after autologous SCT. EBV DNA-emia was significantly more frequent after allogeneic than autologous SCT (60.7% vs 17.4%, p = 0.0002). At EBV reactivation, serum protein electrophoresis and immunofixation were assessed. Global incidence of γ-peak after allogeneic SCT with EBV reactivation was 65.3% (32/49 patients) and monoclonal gammopathy (MG) was identified in 23/28 evaluable patients (82%). All patients with PTLD developed γ-peak and in five of them MG was identified. MG is consistently associated with EBV DNA-emia and may help identification of progression to PTLD after allogeneic SCT.
Chiusolo
Patrizia
P
Institute of Haematology, Rome, Italy.
Metafuni
Elisabetta
E
Cattani
Paola
P
Piccirillo
Nicola
N
Santangelo
Rosaria
R
Manzara
Stefania
S
Bellesi
Silvia
S
De Michele
Teresa
T
Leone
Giuseppe
G
Sica
Simona
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D004854:Herpesvirus 4, Human / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008232:Lymphoproliferative Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D011183:Postoperative Complications; D011446:Prospective Studies; D033581:Stem Cell Transplantation; D019562:Viral Load; D014775:Virus Activation