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全血EB病毒DNA载量对异基因造血干细胞移植后淋巴增殖性疾病的诊断价值
OBJECTIVE: To investigate the diagnostic value of whole blood quantitative PCR for DNA load of Epstein-Barr virus (EBV) in post-transplant lymphoproliferative disease (PTLD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: A total of 694 patients with hematologic diseas...
Formato: | Online Artículo Texto |
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Lenguaje: | English |
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Editorial office of Chinese Journal of Hematology
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763583/ https://www.ncbi.nlm.nih.gov/pubmed/35045651 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2021.11.004 |
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collection | PubMed |
description | OBJECTIVE: To investigate the diagnostic value of whole blood quantitative PCR for DNA load of Epstein-Barr virus (EBV) in post-transplant lymphoproliferative disease (PTLD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: A total of 694 patients with hematologic diseases who underwent allo-HSCT at the Hematology Department of Peking University First Hospital from April 2004 to April 2019 were included, and their data were retrospectively analyzed. RESULTS: ①Among the 694 cases, 29 cases (22 males and 7 females, with a median age of 22 (1–52) years) developed PTLD after allo-HSCT with a cumulative incidence of 4.2% and a median onset time of 2.1 (0.8–20.6) months. ② Univariate analysis showed that age<30 years, diagnosis with aplastic anemia, human leukocyte antigen (HLA) mismatch, use of antithymocyte globulin (ATG) in preconditioning regimens, and EBV reactivation were the risk factors for the occurrence of PTLD. Multivariate analysis showed that EBV reactivation was an independent risk factor for the occurrence of PTLD. ③Further analysis of EBV reactivation cases showed that the peak value of EBV-DNA load was significantly higher in the PTLD group than that in the non-PTLD group (P<0.001) and the incidence of PTLD increased with the increase of EBV-DNA load. Receiver operating characteristic (ROC) curve analysis indicated that PTLD was more likely to be diagnosed when the EBV-DNA load was >1.19×10(6) copies/ml (sensitivity 0.800 and specificity 0.768). ④All patients with PTLD received rituximab-based treatment, with an overall response rate of 86.2% and an overall survival rate of 54.3%. CONCLUSION: The PTLD occurrence after allo-HSCT is highly correlated with EBV reactivation, and the higher the EBV-DNA load, the greater the risk of PTLD occurrence. The dynamic monitoring of EBV-DNA load plays an important role in predicting PTLD occurrence. |
format | Online Article Text |
id | pubmed-8763583 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Editorial office of Chinese Journal of Hematology |
record_format | MEDLINE/PubMed |
spelling | pubmed-87635832022-01-30 全血EB病毒DNA载量对异基因造血干细胞移植后淋巴增殖性疾病的诊断价值 Zhonghua Xue Ye Xue Za Zhi 论著 OBJECTIVE: To investigate the diagnostic value of whole blood quantitative PCR for DNA load of Epstein-Barr virus (EBV) in post-transplant lymphoproliferative disease (PTLD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: A total of 694 patients with hematologic diseases who underwent allo-HSCT at the Hematology Department of Peking University First Hospital from April 2004 to April 2019 were included, and their data were retrospectively analyzed. RESULTS: ①Among the 694 cases, 29 cases (22 males and 7 females, with a median age of 22 (1–52) years) developed PTLD after allo-HSCT with a cumulative incidence of 4.2% and a median onset time of 2.1 (0.8–20.6) months. ② Univariate analysis showed that age<30 years, diagnosis with aplastic anemia, human leukocyte antigen (HLA) mismatch, use of antithymocyte globulin (ATG) in preconditioning regimens, and EBV reactivation were the risk factors for the occurrence of PTLD. Multivariate analysis showed that EBV reactivation was an independent risk factor for the occurrence of PTLD. ③Further analysis of EBV reactivation cases showed that the peak value of EBV-DNA load was significantly higher in the PTLD group than that in the non-PTLD group (P<0.001) and the incidence of PTLD increased with the increase of EBV-DNA load. Receiver operating characteristic (ROC) curve analysis indicated that PTLD was more likely to be diagnosed when the EBV-DNA load was >1.19×10(6) copies/ml (sensitivity 0.800 and specificity 0.768). ④All patients with PTLD received rituximab-based treatment, with an overall response rate of 86.2% and an overall survival rate of 54.3%. CONCLUSION: The PTLD occurrence after allo-HSCT is highly correlated with EBV reactivation, and the higher the EBV-DNA load, the greater the risk of PTLD occurrence. The dynamic monitoring of EBV-DNA load plays an important role in predicting PTLD occurrence. Editorial office of Chinese Journal of Hematology 2021-11 /pmc/articles/PMC8763583/ /pubmed/35045651 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2021.11.004 Text en 2021年版权归中华医学会所有 https://creativecommons.org/licenses/by/3.0/This work is licensed under a Creative Commons Attribution 3.0 License. |
spellingShingle | 论著 全血EB病毒DNA载量对异基因造血干细胞移植后淋巴增殖性疾病的诊断价值 |
title | 全血EB病毒DNA载量对异基因造血干细胞移植后淋巴增殖性疾病的诊断价值 |
title_full | 全血EB病毒DNA载量对异基因造血干细胞移植后淋巴增殖性疾病的诊断价值 |
title_fullStr | 全血EB病毒DNA载量对异基因造血干细胞移植后淋巴增殖性疾病的诊断价值 |
title_full_unstemmed | 全血EB病毒DNA载量对异基因造血干细胞移植后淋巴增殖性疾病的诊断价值 |
title_short | 全血EB病毒DNA载量对异基因造血干细胞移植后淋巴增殖性疾病的诊断价值 |
title_sort | 全血eb病毒dna载量对异基因造血干细胞移植后淋巴增殖性疾病的诊断价值 |
topic | 论著 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763583/ https://www.ncbi.nlm.nih.gov/pubmed/35045651 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2021.11.004 |
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