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Incidence, kinetics, and risk factors of Epstein–Barr virus viremia in pediatric patients after allogeneic stem cell transplantation
Author(s) -
Bordon Victoria,
Padalko Elizaveta,
Benoit Yves,
Dhooge Catharina,
Laureys Genevieve
Publication year - 2012
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.1399-3046.2011.01634.x
Subject(s) - viremia , medicine , hematopoietic stem cell transplantation , transplantation , immunology , incidence (geometry) , epstein–barr virus , virus , virology , physics , optics
Bordon V, Padalko E, Benoit Y, Dhooge C, Laureys G. Incidence, kinetics, and risk factors of Epstein–Barr virus viremia in pediatric patients after allogeneic stem cell transplantation.
Pediatr Transplantation 2012: 16: 144–150. © 2012 John Wiley & Sons A/S. 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.