Epstein-Barr virus (EBV) reactivation is a frequent event after allogeneic stem cell transplantation (SCT) and quantitatively predicts EBV-lymphoproliferative disease following T-cell-depleted SCT

Joost W J Van Esser, Bronno Van Der Holt, Ellen Meijer, Hubert G M Niesters, Rudolf Trenschel, Steven F T Thijsen, Anton M. Van Loon, Francesco Frassoni, Andrea Bacigalupo, Ulrich W. Schaefer, Albert D M E Osterhaus, Jan Willem Gratama, Bob Löwenberg, Leo F. Verdonck, Jan J. Cornelissen

Research output: Contribution to journalArticle

265 Citations (Scopus)

Abstract

Reactivation of the Epstein-Barr virus (EBV) after allogeneic stem cell transplantation (allo-SCT) may evoke a protective cellular immune response or may be complicated by the development of EBV-lymphoproliferative disease (EBV-LPD). So far, very little is known about the incidence, recurrence, and sequelae of EBV reactivation following allo-SCT. EBV reactivation was retrospectively monitored in 85 EBV-seropositive recipients of a T-cell-depleted (TCD) allo-SCT and 65 EBV-seropositive recipients of an unmanipulated allo-SCT. Viral reactivation (more than 50 EBV genome equivalents [gEq]/mL) was monitored frequently by quantitative realtime plasma polymerase chain reaction until day 180 after SCT. Probabilities of developing viral reactivation were high after both unmanipulated and TCD-allogeneic SCT (31% ± 6% versus 65% ± 7%, respectively). A high CD34+ cell number of the graft appeared as a novel significant predictor (P= .001) for EBV reactivation. Recurrent reactivation was observed more frequently in recipients of a TCD graft, and EBV-LPD occurred only after TCD-SCT. High-risk status, TCD, and use of antithymocyte globulin were predictive for developing EBV-LPD. Plasma EBV DNA quantitatively predicted EBV-LPD. The positive and negative predictive values of a viral load of 1000 gEq/mL were, respectively, 39% and 100% after TCD. Treatment-related mortality did not differ significantly between TCD and non-TCD transplants, but the incidence of chronic graft-versus-host disease was significantly less in TCD patients. It is concluded that EBV reactivation occurs frequently after TCD and unmanipulated allo-SCT, especially in recipients of grafts with high CD34+ cell counts. EBV-LPD, however, occurred only after TCD, and EBV load quantitatively predicted EBV-LPD in recipients of a TCD graft.

Original languageEnglish
Pages (from-to)972-978
Number of pages7
JournalBlood
Volume98
Issue number4
DOIs
Publication statusPublished - Aug 15 2001

Fingerprint

T-cells
Stem Cell Transplantation
Virus Diseases
Stem cells
Human Herpesvirus 4
Viruses
T-Lymphocytes
Grafts
Transplants
Cell Count
Genes
Genome
Plasmas
Antilymphocyte Serum
Polymerase chain reaction
Incidence
Graft vs Host Disease
Viral Load
Cellular Immunity

ASJC Scopus subject areas

  • Hematology

Cite this

Epstein-Barr virus (EBV) reactivation is a frequent event after allogeneic stem cell transplantation (SCT) and quantitatively predicts EBV-lymphoproliferative disease following T-cell-depleted SCT. / Van Esser, Joost W J; Van Der Holt, Bronno; Meijer, Ellen; Niesters, Hubert G M; Trenschel, Rudolf; Thijsen, Steven F T; Van Loon, Anton M.; Frassoni, Francesco; Bacigalupo, Andrea; Schaefer, Ulrich W.; Osterhaus, Albert D M E; Gratama, Jan Willem; Löwenberg, Bob; Verdonck, Leo F.; Cornelissen, Jan J.

In: Blood, Vol. 98, No. 4, 15.08.2001, p. 972-978.

Research output: Contribution to journalArticle

Van Esser, JWJ, Van Der Holt, B, Meijer, E, Niesters, HGM, Trenschel, R, Thijsen, SFT, Van Loon, AM, Frassoni, F, Bacigalupo, A, Schaefer, UW, Osterhaus, ADME, Gratama, JW, Löwenberg, B, Verdonck, LF & Cornelissen, JJ 2001, 'Epstein-Barr virus (EBV) reactivation is a frequent event after allogeneic stem cell transplantation (SCT) and quantitatively predicts EBV-lymphoproliferative disease following T-cell-depleted SCT', Blood, vol. 98, no. 4, pp. 972-978. https://doi.org/10.1182/blood.V98.4.972
Van Esser, Joost W J ; Van Der Holt, Bronno ; Meijer, Ellen ; Niesters, Hubert G M ; Trenschel, Rudolf ; Thijsen, Steven F T ; Van Loon, Anton M. ; Frassoni, Francesco ; Bacigalupo, Andrea ; Schaefer, Ulrich W. ; Osterhaus, Albert D M E ; Gratama, Jan Willem ; Löwenberg, Bob ; Verdonck, Leo F. ; Cornelissen, Jan J. / Epstein-Barr virus (EBV) reactivation is a frequent event after allogeneic stem cell transplantation (SCT) and quantitatively predicts EBV-lymphoproliferative disease following T-cell-depleted SCT. In: Blood. 2001 ; Vol. 98, No. 4. pp. 972-978.
@article{c902b18b50944cc3bbb3d3a1dc231ff9,
title = "Epstein-Barr virus (EBV) reactivation is a frequent event after allogeneic stem cell transplantation (SCT) and quantitatively predicts EBV-lymphoproliferative disease following T-cell-depleted SCT",
abstract = "Reactivation of the Epstein-Barr virus (EBV) after allogeneic stem cell transplantation (allo-SCT) may evoke a protective cellular immune response or may be complicated by the development of EBV-lymphoproliferative disease (EBV-LPD). So far, very little is known about the incidence, recurrence, and sequelae of EBV reactivation following allo-SCT. EBV reactivation was retrospectively monitored in 85 EBV-seropositive recipients of a T-cell-depleted (TCD) allo-SCT and 65 EBV-seropositive recipients of an unmanipulated allo-SCT. Viral reactivation (more than 50 EBV genome equivalents [gEq]/mL) was monitored frequently by quantitative realtime plasma polymerase chain reaction until day 180 after SCT. Probabilities of developing viral reactivation were high after both unmanipulated and TCD-allogeneic SCT (31{\%} ± 6{\%} versus 65{\%} ± 7{\%}, respectively). A high CD34+ cell number of the graft appeared as a novel significant predictor (P= .001) for EBV reactivation. Recurrent reactivation was observed more frequently in recipients of a TCD graft, and EBV-LPD occurred only after TCD-SCT. High-risk status, TCD, and use of antithymocyte globulin were predictive for developing EBV-LPD. Plasma EBV DNA quantitatively predicted EBV-LPD. The positive and negative predictive values of a viral load of 1000 gEq/mL were, respectively, 39{\%} and 100{\%} after TCD. Treatment-related mortality did not differ significantly between TCD and non-TCD transplants, but the incidence of chronic graft-versus-host disease was significantly less in TCD patients. It is concluded that EBV reactivation occurs frequently after TCD and unmanipulated allo-SCT, especially in recipients of grafts with high CD34+ cell counts. EBV-LPD, however, occurred only after TCD, and EBV load quantitatively predicted EBV-LPD in recipients of a TCD graft.",
author = "{Van Esser}, {Joost W J} and {Van Der Holt}, Bronno and Ellen Meijer and Niesters, {Hubert G M} and Rudolf Trenschel and Thijsen, {Steven F T} and {Van Loon}, {Anton M.} and Francesco Frassoni and Andrea Bacigalupo and Schaefer, {Ulrich W.} and Osterhaus, {Albert D M E} and Gratama, {Jan Willem} and Bob L{\"o}wenberg and Verdonck, {Leo F.} and Cornelissen, {Jan J.}",
year = "2001",
month = "8",
day = "15",
doi = "10.1182/blood.V98.4.972",
language = "English",
volume = "98",
pages = "972--978",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "4",

}

TY - JOUR

T1 - Epstein-Barr virus (EBV) reactivation is a frequent event after allogeneic stem cell transplantation (SCT) and quantitatively predicts EBV-lymphoproliferative disease following T-cell-depleted SCT

AU - Van Esser, Joost W J

AU - Van Der Holt, Bronno

AU - Meijer, Ellen

AU - Niesters, Hubert G M

AU - Trenschel, Rudolf

AU - Thijsen, Steven F T

AU - Van Loon, Anton M.

AU - Frassoni, Francesco

AU - Bacigalupo, Andrea

AU - Schaefer, Ulrich W.

AU - Osterhaus, Albert D M E

AU - Gratama, Jan Willem

AU - Löwenberg, Bob

AU - Verdonck, Leo F.

AU - Cornelissen, Jan J.

PY - 2001/8/15

Y1 - 2001/8/15

N2 - Reactivation of the Epstein-Barr virus (EBV) after allogeneic stem cell transplantation (allo-SCT) may evoke a protective cellular immune response or may be complicated by the development of EBV-lymphoproliferative disease (EBV-LPD). So far, very little is known about the incidence, recurrence, and sequelae of EBV reactivation following allo-SCT. EBV reactivation was retrospectively monitored in 85 EBV-seropositive recipients of a T-cell-depleted (TCD) allo-SCT and 65 EBV-seropositive recipients of an unmanipulated allo-SCT. Viral reactivation (more than 50 EBV genome equivalents [gEq]/mL) was monitored frequently by quantitative realtime plasma polymerase chain reaction until day 180 after SCT. Probabilities of developing viral reactivation were high after both unmanipulated and TCD-allogeneic SCT (31% ± 6% versus 65% ± 7%, respectively). A high CD34+ cell number of the graft appeared as a novel significant predictor (P= .001) for EBV reactivation. Recurrent reactivation was observed more frequently in recipients of a TCD graft, and EBV-LPD occurred only after TCD-SCT. High-risk status, TCD, and use of antithymocyte globulin were predictive for developing EBV-LPD. Plasma EBV DNA quantitatively predicted EBV-LPD. The positive and negative predictive values of a viral load of 1000 gEq/mL were, respectively, 39% and 100% after TCD. Treatment-related mortality did not differ significantly between TCD and non-TCD transplants, but the incidence of chronic graft-versus-host disease was significantly less in TCD patients. It is concluded that EBV reactivation occurs frequently after TCD and unmanipulated allo-SCT, especially in recipients of grafts with high CD34+ cell counts. EBV-LPD, however, occurred only after TCD, and EBV load quantitatively predicted EBV-LPD in recipients of a TCD graft.

AB - Reactivation of the Epstein-Barr virus (EBV) after allogeneic stem cell transplantation (allo-SCT) may evoke a protective cellular immune response or may be complicated by the development of EBV-lymphoproliferative disease (EBV-LPD). So far, very little is known about the incidence, recurrence, and sequelae of EBV reactivation following allo-SCT. EBV reactivation was retrospectively monitored in 85 EBV-seropositive recipients of a T-cell-depleted (TCD) allo-SCT and 65 EBV-seropositive recipients of an unmanipulated allo-SCT. Viral reactivation (more than 50 EBV genome equivalents [gEq]/mL) was monitored frequently by quantitative realtime plasma polymerase chain reaction until day 180 after SCT. Probabilities of developing viral reactivation were high after both unmanipulated and TCD-allogeneic SCT (31% ± 6% versus 65% ± 7%, respectively). A high CD34+ cell number of the graft appeared as a novel significant predictor (P= .001) for EBV reactivation. Recurrent reactivation was observed more frequently in recipients of a TCD graft, and EBV-LPD occurred only after TCD-SCT. High-risk status, TCD, and use of antithymocyte globulin were predictive for developing EBV-LPD. Plasma EBV DNA quantitatively predicted EBV-LPD. The positive and negative predictive values of a viral load of 1000 gEq/mL were, respectively, 39% and 100% after TCD. Treatment-related mortality did not differ significantly between TCD and non-TCD transplants, but the incidence of chronic graft-versus-host disease was significantly less in TCD patients. It is concluded that EBV reactivation occurs frequently after TCD and unmanipulated allo-SCT, especially in recipients of grafts with high CD34+ cell counts. EBV-LPD, however, occurred only after TCD, and EBV load quantitatively predicted EBV-LPD in recipients of a TCD graft.

UR - http://www.scopus.com/inward/record.url?scp=0035883085&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035883085&partnerID=8YFLogxK

U2 - 10.1182/blood.V98.4.972

DO - 10.1182/blood.V98.4.972

M3 - Article

C2 - 11493441

AN - SCOPUS:0035883085

VL - 98

SP - 972

EP - 978

JO - Blood

JF - Blood

SN - 0006-4971

IS - 4

ER -