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Incidence, kinetics, and risk factors of Epstein-Barr virus viremia in pediatric patients after allogeneic stem cell transplantation

Maria Bordon Cueto De Braem (UGent) , Elizaveta Padalko (UGent) , Yves Benoit (UGent) , Catharina Dhooge (UGent) and Genevieve Laureys (UGent)
(2012) PEDIATRIC TRANSPLANTATION. 16(2). p.144-150
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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.
Keywords
Epstein-Barr virus infections, EBV-LYMPHOPROLIFERATIVE DISEASE, children, RITUXIMAB, allogeneic stem cell transplantation, SCT, DISORDERS, HYPOGAMMAGLOBULINEMIA, INTERVENTION, RECOVERY, LOAD, PCR

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MLA
Bordon Cueto De Braem, Maria, et al. “Incidence, Kinetics, and Risk Factors of Epstein-Barr Virus Viremia in Pediatric Patients after Allogeneic Stem Cell Transplantation.” PEDIATRIC TRANSPLANTATION, vol. 16, no. 2, 2012, pp. 144–50, doi:10.1111/j.1399-3046.2011.01634.x.
APA
Bordon Cueto De Braem, M., Padalko, E., Benoit, Y., Dhooge, C., & Laureys, G. (2012). Incidence, kinetics, and risk factors of Epstein-Barr virus viremia in pediatric patients after allogeneic stem cell transplantation. PEDIATRIC TRANSPLANTATION, 16(2), 144–150. https://doi.org/10.1111/j.1399-3046.2011.01634.x
Chicago author-date
Bordon Cueto De Braem, Maria, Elizaveta Padalko, Yves Benoit, Catharina Dhooge, and Genevieve Laureys. 2012. “Incidence, Kinetics, and Risk Factors of Epstein-Barr Virus Viremia in Pediatric Patients after Allogeneic Stem Cell Transplantation.” PEDIATRIC TRANSPLANTATION 16 (2): 144–50. https://doi.org/10.1111/j.1399-3046.2011.01634.x.
Chicago author-date (all authors)
Bordon Cueto De Braem, Maria, Elizaveta Padalko, Yves Benoit, Catharina Dhooge, and Genevieve Laureys. 2012. “Incidence, Kinetics, and Risk Factors of Epstein-Barr Virus Viremia in Pediatric Patients after Allogeneic Stem Cell Transplantation.” PEDIATRIC TRANSPLANTATION 16 (2): 144–150. doi:10.1111/j.1399-3046.2011.01634.x.
Vancouver
1.
Bordon Cueto De Braem M, 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. PEDIATRIC TRANSPLANTATION. 2012;16(2):144–50.
IEEE
[1]
M. Bordon Cueto De Braem, E. Padalko, Y. Benoit, C. Dhooge, and G. Laureys, “Incidence, kinetics, and risk factors of Epstein-Barr virus viremia in pediatric patients after allogeneic stem cell transplantation,” PEDIATRIC TRANSPLANTATION, vol. 16, no. 2, pp. 144–150, 2012.
@article{2963277,
  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.}},
  author       = {{Bordon Cueto De Braem, Maria and Padalko, Elizaveta and Benoit, Yves and Dhooge, Catharina and Laureys, Genevieve}},
  issn         = {{1397-3142}},
  journal      = {{PEDIATRIC TRANSPLANTATION}},
  keywords     = {{Epstein-Barr virus infections,EBV-LYMPHOPROLIFERATIVE DISEASE,children,RITUXIMAB,allogeneic stem cell transplantation,SCT,DISORDERS,HYPOGAMMAGLOBULINEMIA,INTERVENTION,RECOVERY,LOAD,PCR}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{144--150}},
  title        = {{Incidence, kinetics, and risk factors of Epstein-Barr virus viremia in pediatric patients after allogeneic stem cell transplantation}},
  url          = {{http://dx.doi.org/10.1111/j.1399-3046.2011.01634.x}},
  volume       = {{16}},
  year         = {{2012}},
}
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