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Prospective monitoring of the Epstein–Barr virus DNA by a real‐time quantitative polymerase chain reaction after allogenic stem cell transplantation
Author(s) -
Hoshino Yo,
Kimura Hiroshi,
Tanaka Naoko,
Tsuge Ikuya,
Kudo Kazuko,
Horibe Keizo,
Kato Koji,
Matsuyama Takaharu,
Kikuta Atsushi,
Kojima Seiji,
Morishima Tsuneo
Publication year - 2001
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2001.03087.x
Subject(s) - viral load , hematopoietic stem cell transplantation , transplantation , polymerase chain reaction , real time polymerase chain reaction , medicine , virus , immunology , viral disease , torque teno virus , epstein–barr virus , virology , gastroenterology , biology , biochemistry , gene
Epstein‐Barr virus (EBV)‐related lymphoproliferative disorder (LPD) is a serious complication of haematopoietic stem cell transplantation (HSCT). To clarify the frequency, natural course and risk factors for LPD, we prospectively monitored 38 allogeneic (allo)‐HSCT patients, focusing on the use of anti‐thymocyte globulin (ATG). We used a recently developed real‐time polymerase chain reaction assay to monitor EBV genome load. The subjects consisted of 19 patients given ATG for conditioning and 19 patients not given ATG. Of the 19 patients given ATG, 47·4% (nine patients) had a significant increase in EBV genome load (10 2·5 copies/µg DNA). Of these nine patients, two developed LPD. Therefore, 10·5% of the patients receiving allo‐HSCT with ATG developed LPD. In contrast, none of the 19 patients without ATG had a significantly increased EBV load. The increases in viral load were observed in the second or third month after HSCT. We found that the peak viral loads of LPD patients were > 10 4·0 copies/µg DNA. On the other hand, the viral loads of most patients with no symptoms were < 10 2·5 copies/µg DNA. In conclusion, routine monitoring of EBV load during the second and third months after transplantation may benefit patients undergoing HSCT with ATG. We propose that an EBV load > 10 2·5 copies/µg DNA is the reactivation of EBV, and that an EBV load > 10 4·0 copies/µg DNA is indicative of developing LPD.