Late‐onset Epstein–Barr virus‐related disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation is associated with impaired early recovery of <scp>T</scp> and <scp>B</scp> lymphocytes

Liu, Jiangying; Yan, Chen‐Hua; Zhang, Chunli; Xu, Lei; Liu, Yanrong; Huang, Xiao‐Jun

doi:10.1111/ctr.12593

Cited by 4 publications

(1 citation statement)

References 27 publications

(31 reference statements)

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“…The results of this paper found that EBV infection was associated with the immunophenotype of the children, with the number of B-cell type cases being higher than the T-cell type in the infected group, which further suggests that the target cells of EBV are B-cells. However, a study has shown (22) that EBV can also infect mononuclear macrophages, natural killer cells, and T lymphocytes. This paper found that 12.87% of EBV-infected children were of the T-cell type and that there was a significant difference in the T-lymphocyte subpopulation index between these children and non-infected children, suggesting that EBV can infect T-lymphocytes in addition to B-lymphocytes, thus affecting the relevant index.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and prognosis of acute lymphoblastic leukemia in children with Epstein-Barr virus infection

Deng¹,

Xu²,

Yuan³

2022

Transl Pediatr

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Background: Acute lymphoblastic leukemia (ALL) is one of the most common malignant diseases of the hematopoietic system in children. Although the etiology of ALL is unknown, it has been reported that it may be associated with Epstein-Barr virus (EBV) infection. The aim of this study was to analyze the impact of EBV infection on the clinical features and prognosis of childhood ALL.Methods: A total of 162 children with ALL admitted to Heilongjiang Provincial Hospital from January 2018 to December 2020 were selected for this stud, and were divided into 2 groups, infected group and noninfected group, according to whether they had EBV infection. Differences in clinical characteristics between the 2 groups were analyzed by χ 2 or t-test. The impact of EBV infection on the prognosis of children was analyzed by Kaplan-Meier survival and Cox regression analysis. Results:The 2 groups were statistically significantly different (P<0.05) according to comparison of characteristics such as first symptoms, karyotype, immunophenotyping, clinical risk, whether secondary infection occurred during chemotherapy, and lymphocyte subsets. Logistic regression results suggested that first symptoms, karyotype, immunophenotyping, clinical risk, the presence of secondary infection during chemotherapy, and lymphocyte subsets were independently associated with EBV infection in children with ALL (P<0.05). The complete remission rate at 46 days after chemotherapy, event-free survival (EFS), overall survival (OS), and survival rate were lower in the infected group than non-infected group, and the complete remission recurrence rate was higher than non-infected group (P<0.05). The EBV DNA levels were statistically lower in the good prognosis group (1.07±0.25×10 3 copies/L) than poor prognosis group (8.86±1.14 ×10 3 copies/L) (P<0.01). The area under the curve (AUC) for EBV to predict prognosis in children with ALL was 0.921, sensitivity and sensitivity were 86.57%, 80.16%.Conclusions: Infection with EBV is associated with first symptoms, karyotype, immunophenotyping, clinical risk, secondary infection during chemotherapy, and lymphocyte subpopulation index levels in children with ALL, and children with EBV infection have a reduced clinical remission rate and poor prognosis. Therefore, the detection of EBV DNA is clinically important for assessing the prognosis of their disease.

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Section: Discussionmentioning

confidence: 99%

Clinical features and prognosis of acute lymphoblastic leukemia in children with Epstein-Barr virus infection

Deng¹,

Xu²,

Yuan³

2022

Transl Pediatr

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Risk factors and associations with clinical outcomes of cytomegalovirus reactivation after haploidentical versus matched-sibling unmanipulated PBSCT in patients with hematologic malignancies

et al. 2020

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Epstein-Barr Virus–Related Post-Transplantation Lymphoproliferative Disorder after Unmanipulated Human Leukocyte Antigen Haploidentical Hematopoietic Stem Cell Transplantation: Incidence, Risk Factors, Treatment, and Clinical Outcomes

Zhang

et al. 2015

Biology of Blood and Marrow Transplantation

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We examined the incidence, risk factors, treatments, and clinical outcomes of post-transplantation lymphoproliferative disorder (PTLD) after unmanipulated haploidentical (haplo) hematopoietic stem cell transplantation (HSCT) in 1184 patients between 2006 and 2012. Age-, transplantation time-, and transplantation duration-matched controls were randomly selected from the same cohort. Forty-five patients experienced PTLD. The median time from HSCT to PTLD occurrence was 61 (range, 33 to 360) days and the 1-year cumulative incidence of total PTLD after haplo-HSCT was 3.0%. In multivariate analysis, a lower absolute count of CD8(+) T lymphocytes at day 30, a lower absolute count of immunoglobulin M at day 30, and cytomegalovirus DNAemia after HSCT were significantly associated with higher risk of PTLD. The 2-year probability of overall survival (OS) after HSCT was 42.8%, which was comparable between the probable PTLD and the proven PTLD patients. Patients who received rituximab-based therapy had significantly better 2-year OS (48.2% versus 13.2%, P = .02). Thus, we were able to identify individuals at a high risk of developing PTLD after unmanipulated haplo-HSCT. Rituximab-based therapy can help to improve the outcomes of PTLD patients.

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Late‐onset Epstein–Barr virus‐related disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation is associated with impaired early recovery of T and B lymphocytes

Cited by 4 publications

References 27 publications

Clinical features and prognosis of acute lymphoblastic leukemia in children with Epstein-Barr virus infection

Clinical features and prognosis of acute lymphoblastic leukemia in children with Epstein-Barr virus infection

Risk factors and associations with clinical outcomes of cytomegalovirus reactivation after haploidentical versus matched-sibling unmanipulated PBSCT in patients with hematologic malignancies

Epstein-Barr Virus–Related Post-Transplantation Lymphoproliferative Disorder after Unmanipulated Human Leukocyte Antigen Haploidentical Hematopoietic Stem Cell Transplantation: Incidence, Risk Factors, Treatment, and Clinical Outcomes

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