Prospective monitoring of the Epstein–Barr virus DNA by a real-time quantitative polymerase chain reaction after allogenic stem cell transplantation

Authors

  • Yo Hoshino,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • 1 Hiroshi Kimura,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • 1 Naoko Tanaka,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • 1 Ikuya Tsuge,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • 1 Kazuko Kudo,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • 1 Keizo Horibe,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • 1 Koji Kato,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • 2 Takaharu Matsuyama,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • 2 Atsushi Kikuta,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • 3 Seiji Kojima,


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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  • and 1 Tsuneo Morishima 4


    1. Department of 1Paediatrics/Developmental Paediatrics, Nagoya University School of Medicine, Nagoya,
      2Division of Haematology/Oncology Japanese Red Cross First Hospital, Nagoya, 3Department of Paediatrics,
      Fukushima Medical University, Fukushima, and
      4Department of Health Science, Nagoya University School of Medicine, Nagoya, Japan
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Yo Hoshino, MD, Department of Paediatrics, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466–8550, Japan. E-mail: yoho@med.nagoya-u.ac.jp

Abstract

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 (102·5 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 > 104·0 copies/µg DNA. On the other hand, the viral loads of most patients with no symptoms were < 102·5 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 > 102·5 copies/µg DNA is the reactivation of EBV, and that an EBV load > 104·0 copies/µg DNA is indicative of developing LPD.

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