Pattern Analysis of Epstein-Barr Virus Viremia and Its Significance in the Evaluation of Organ Transplant Patients Suspected of Having Posttransplant Lymphoproliferative Disorders

Abstract

We believe that pattern analysis of EBV DNA quantitation results could lead to the early diagnosis and timely treatment of PTLD.

Presentation and management of post-allogeneic transplantation EBV-positive mucocutaneous ulcer

“…The development of PTLD has previously been shown to correlate with EBV viremia. 6 In contrast, our patient did not have a detectable EBV viral load by PCR despite a positive EBV in situ hybridization study on biopsy. Negative EBV viral loads, in fact, are characteristic for EBV+ MCU.…”

Post-transplant lymphoproliferative disorders: From epidemiology to pathogenesis-driven treatment

“…These uncontrolled EBV-driven lymphoproliferations are the best examples of the critical role played by host immunity in controlling EBV infection. In the setting of 3 pediatric PTLD patient PBMC and plasma In-house quantitative PCR >1000 copies/10 5 PBMC and >500 copies/ml [64] 57 transplant patients Serum In-house real-time PCR >50,000 copies/ml high risk of PTLD [69] 1 pediatric PTLD patient Plasma In-house real-time PCR >200 copies/ml [70] 3 pediatric PTLD patient Serum In-house nested PCR >5000 copies/ml [52] 6 adults at PTLD diagnosis Whole blood In-house quantitative competitive PCR >1000 copies/ml [59] 264 pediatric transplant patients Whole blood In-house real-time PCR >30,000 copies/ml [60] 6 adults at PTLD diagnosis Whole blood In-house quantitative competitive PCR >2000 copies/ml [61] 2 pediatric PTLD patient Whole blood In-house semi-quantitative nested PCR >30,000 copies/ml [62] 53 transplant patients Whole blood In-house real-time PCR >100,000 copies/ml high risk of PTLD [63] 41 transplant patients Whole blood Commercially available real-time PCR >100,000 copies/ml high risk of PTLD a Peripheral blood mononuclear cells. iatrogenic immune suppression which characterizes transplant patients, EBV-infected lymphoid cells may proliferate and expand, thanks to the driving force of several EBV antigens expressed during latency, mainly LMP-1.…”

“…Several studies have demonstrated that PTLD is accompanied by a significant increase in EBV levels in peripheral blood mononuclear cells (PBMC) [50,[53][54][55][56][57][58] and in whole peripheral blood [59][60][61][62][63]. In particular, increased levels of EBV-DNA in serum or whole blood have been found to be predictive of PTLD onset in post-transplant patients [62][63][64]. Nevertheless, high EBV-DNA alone is not always predictive of impending PTLD [51,65,66].…”

“…Unfortunately, defining a cut-off value seems to be quite difficult, since several studies (2000-2015) have reported varying values of EBV load [50,52,[55][56][57][58][59][60][61][62][63][64]69,70] (Table 3).…”

Collision tumor of colonic adenocarcinoma and EBV-driven large B-cell lymphoma: A case report and review of literature

“…This can be seen in the increased risk of lymphoma in patients with inflammatory bowel disease on immunosuppression [23][24][25]. The incidence of post-transplant lymphoproliferative disorders has been shown to increase with EBV viral load [26]. EBV has also been detected in colorectal adenocarcinoma, suggesting it as a possible contributing factor [27][28].…”