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Role of Epstein-Barr virus DNA load monitoring in prevention and early detection of post-transplant lymphoproliferative disease

Stevens, S. J. C., Verschuuren, E. A. M., Verkuujlen, S. A. W. M., Van Den Brule, A. J. C., Meijer, C. J. L. M. & Middeldorp, J. M., Apr-2002, In : Leukemia and Lymphoma. 43, 4, p. 831-840 10 p.

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  • Role of Epstein-Barr Virus DNA Load Monitoring

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DOI

  • Servi J C Stevens
  • Erik A M Verschuuren
  • Sandra A W M Verkuujlen
  • Adriaan J C Van Den Brule
  • Chris J L M Meijer
  • Jaap M Middeldorp

Posttransplant lymphoproliferative disease (PTLD) is a severe and life-threatening complication after stem cell or solid-organ transplantation, virtually always associated with presence of Epstein-Barr virus (EBV) in the proliferating cells. PTLD is probably caused by the iatrogenically impaired T-cell response allowing outgrowth of EBV-positive B-cells. Quantitative EBV DNA load monitoring is a minimally invasive technique increasingly recognized as a valuable tool in posttransplant patient management. In this review, we focus on the clinical utility of EBV DNA load monitoring in the peripheral blood of transplant recipients using PCR and we discuss the currently most-widely used techniques and their value and limitations in predicting and diagnosing PTLD. Options for EBV DNA load-guided pre-emptive therapy and application of monitoring EBV DNA load dynamics in the prediction of clinical response after therapy are described. Origins of elevated EBV DNA loads in immunosuppressed patients and recent insights in the EBV life cycle in the immuncompromised host are discussed. Finally, a standardization of methodology, clinical specimen type, and cut-off values is proposed. This is essential for comparisons between different institutes and more adequate patient management.

Original languageEnglish
Pages (from-to)831-840
Number of pages10
JournalLeukemia and Lymphoma
Volume43
Issue number4
Publication statusPublished - Apr-2002

    Keywords

  • DNA, Viral/analysis, Herpesvirus 4, Human/genetics, Humans, Lymphoproliferative Disorders/diagnosis, Organ Transplantation/adverse effects, Polymerase Chain Reaction, Prognosis, RNA, Viral/analysis, Stem Cell Transplantation/adverse effects, Viral Load

ID: 59907997