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Long‐term monitoring of Epstein–Barr virus DNA load and humoral parameter abnormalities in pediatric liver transplant recipients before development of malignancy
Author(s) -
Gregorek Hanna,
Jankowska Irena,
DzierżanowskaFangrat Katarzyna,
Teisseyre Joanna,
Sawicka Anna,
Kasztelewicz Beata,
Pawłowska Joanna
Publication year - 2010
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2010.01293.x
Subject(s) - hypergammaglobulinemia , medicine , viral load , immunosuppression , malignancy , immunology , isotype , virus , liver transplantation , epstein–barr virus , transplantation , gastroenterology , antibody , monoclonal antibody
Gregorek H, Jankowska I, Dzierżanowska‐Fangrat K, Teisseyre J, Sawicka A, Kasztelewicz B, Pawłowska J. Long‐term monitoring of Epstein–Barr virus DNA load and humoral parameter abnormalities in pediatric liver transplant recipients before development of malignancy.
Pediatr Transplantation 2010: 14:629–635. © 2010 John Wiley & Sons A/S. Abstract: EBV loads and abnormalities of humoral responses were monitored in 51 pediatric liver transplant recipients as a proposed non‐invasive laboratory tool for early detection of changes preceding severe clinical complications. EBV DNA load, concentrations of IgM, IgG, IgA, and monoclonal proteins were determined in each blood sample. EBV DNA was detected in 70.6% of the children, dysgammaglobulinemia of one or more Ig isotype was present in 41.2% of them. MG detected in 43.1% of patients correlated with the presence of EBV DNA (p = 0.003) and was usually preceded by hypergammaglobulinemia. The median maximum EBV load was significantly higher in EBV DNA+/MG+ patients than in EBV DNA+/MG‐ patients (p = 0.04), although there was no correlation between current viral load and appearance of MG. Four of 15 EBV DNA‐negative patients developed MG, preceded by hypergammaglobulinemia in two. Minimization or cessation of immunosuppression in 42 patients, in whom abnormal biomarkers and/or clinical symptoms raised suspicion of disease progression, permitted complete resolution of abnormalities in all but one patient who developed B‐NHL and died. Simultaneous monitoring of protein profiles and EBV DNA load together with thorough physical evaluation of children after LTx is important for early implementation of suitable preemptive therapy.