Monitoring and modulation of Epstein-Barr virus loads in pediatric transplant patients.

摘要: A major risk faced by bone-marrow and solid organ transplant patients is the development of post-transplant lymphoproliferative disease or lymphoma (PTLD). In pediatric transplantation, PTLD onset often associated with a rapid rise in Epstein-Barr virus (EBV) load peripheral blood mononuclear cells (PBMC). We have analyzed EBV viral loads PBMC over time using real-time quantitative PCR 56 patients, 19 which been followed for more than 1 year. nine patients; eight bone marrow (BMT) one kidney transplant, was load, exceeding x 10(5) genomes/microg PBMC-derived DNA. Four these exceeded 10(6) All DNA were clearly at high transplant-associated mortality, only six surviving. Importantly, deaths directly attributable to EBV. second elevated state defined as 2 10(4) PBMC, seen total 12 BMT, kidney, heart, liver patients. These did not appear be immediate lethal EBV-attributable death found this group well. Thirty-four whose oscillated from undetectable 10 000 are reported The threshold normal based on our combined experience analysis ability rapidly analyze allows changes such those that occur onset, impact anti-CD20 antibody therapy detected.