title: Incidence, kinetics, and risk factors of Epstein-Barr virus viremia in pediatric patients after allogeneic stem cell transplantation.
abstract: After allogeneic hematopoietic stem-cell transplantation (allo-HSCT), EBV infections can be potentially dangerous and even life threatening. We evaluated the EBV viremia in 80 consecutive allo-HSCT with quantitative EBV-PCR every 2 weeks during the first 3 months and monthly thereafter until 1 yr after allo-HSCT or until death. We found a significantly more frequent viremia in patients who had in vivo T-cell depletion in which 23 out of 51 (45%) had EBV-PCR positivity. The EBV virus load was also significantly higher in the in vivo T-cell depleted group. Three patients developed clinical symptoms of EBV-PTLD and were treated with monoclonal anti-CD20 antibodies. No EBV- driven mortality was seen in this cohort. In our opinion EBV-PCR monitoring is mandatory after allo-HSCT. Most of the patients with EBV viremia had a good evolution after tapering the immune suppression, so this should be the first-line management of pediatric patients with EBV viremia. Monoclonal anti-CD20 antibodies should be reserved for those patients with early symptoms of EBV-PTLD.
authors.affiliation: Pediatric Hematology Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium. victoria.bordon@uzgent.be
authors.forename: Victoria
authors.initials: V
authors.lastname: Bordon
authors.forename: Elizaveta
authors.initials: E
authors.lastname: Padalko
authors.forename: Yves
authors.initials: Y
authors.lastname: Benoit
authors.forename: Catharina
authors.initials: C
authors.lastname: Dhooge
authors.forename: Genevieve
authors.initials: G
authors.lastname: Laureys
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D015994:Incidence; D007223:Infant; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014766:Viremia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D007166:Immunosuppressive Agents