title: Late-onset Epstein-Barr virus-related disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation is associated with impaired early recovery of T and B lymphocytes.
abstract: Epstein-Barr virus-related disease (EBVD) is a serious clinical complication in patients who have undergone haploidentical hematopoietic stem cell transplantation (haploHSCT). Some recipients develop EBVD relatively late after haploHSCT, and most of these patients suffer a poor outcome. This retrospective cohort study characterized the early adaptive immune recovery of patients with acute leukemia presenting with EBVD more than 100 d after haploHSCT. Patients with acute leukemia who received haploHSCT and developed EBVD 100 d later (n = 8) were compared with a matched control group without EBVD (n = 24) with regard to peripheral WBC, lymphocytes, and neutrophils (at 30, 60, and 90 d) and recoveries of B and T lymphocytes (at 30 and 90 d, via immunophenotyping/flow cytometry). Ninety days after haploHSCT, the median values of WBCs and lymphocytes, and the recoveries of CD19(+) B cells and CD4(+) , CD8(+) , and CD4(+) CD45RO(+) T cells, were significantly lower in patients who developed EBVD, relative to the control group. These results suggest a significant association between deficient early recovery of B and T lymphocytes and the development of late-onset EBVD after haploHSCT. Our observation could facilitate clinical intervention and the improvement of overall survival of patients undergoing haploHSCT.
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: Jiangying
authors.initials: J
authors.lastname: Liu
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: Chenhua
authors.initials: C
authors.lastname: Yan
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: Chunli
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: Lanping
authors.initials: L
authors.lastname: Xu
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: Yanrong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Huang
mesh_terms: D056704:Adaptive Immunity; D000293:Adolescent; D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology*; D002648:Child; D020031:Epstein-Barr Virus Infections / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000276:immunology / Q000628:therapy* / Q000821:virology; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000628:therapy* / Q000821:virology; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: EBV-related disease; Epstein-Barr virus; acute leukemia; hematopoietic stem cell transplantation; immune reconstitution