Institute of Haematology, Rome, Italy.
J Clin Immunol. 2010 Nov;30(6):894-902. doi: 10.1007/s10875-010-9454-x. Epub 2010 Aug 25.
Epstein-Barr Virus (EBV) reactivation and EBV-related post-transplant lymphoproliferative disease (PTLD) have emerged as a severe complication after stem cell transplantation (SCT). We prospectively evaluated 104 consecutive patients receiving SCT either autologous or allogeneic. Fifty-two patients (50%) presented EBV DNA-emia and five of them developed PTLD proven or probable. PTLD rate was 9.6% among patients with EBV DNA-emia. One patient developed PTLD without EBV DNA-emia (0.96%). Overall PTLD incidence was 5.7%. No PTLD developed after autologous SCT. EBV DNA-emia was significantly more frequent after allogeneic than autologous SCT (60.7% vs 17.4%, p = 0.0002). At EBV reactivation, serum protein electrophoresis and immunofixation were assessed. Global incidence of γ-peak after allogeneic SCT with EBV reactivation was 65.3% (32/49 patients) and monoclonal gammopathy (MG) was identified in 23/28 evaluable patients (82%). All patients with PTLD developed γ-peak and in five of them MG was identified. MG is consistently associated with EBV DNA-emia and may help identification of progression to PTLD after allogeneic SCT.
题目：移植后 EBV 病毒（EBV）再激活与 EBV 相关的淋巴增殖性疾病（PTLD）已成为干细胞移植（SCT）后的严重并发症。
方法：我们前瞻性评估了 104 例接受自体或同种异体 SCT 的连续患者。
结果：52 例（50%）患者出现 EBV DNA-emia，其中 5 例发生经证实或可能的 PTLD。
结论：PTLD 发生率在 EBV DNA-emia 患者中为 9.6%。1 例患者发生了无 EBV DNA-emia 的 PTLD（0.96%）。
结论：总体 PTLD 发生率为 5.7%。
结论：自体 SCT 后无 PTLD 发生。
结论：同种异体 SCT 后 EBV DNA-emia 明显比自体 SCT 更常见（60.7% vs 17.4%，p = 0.0002）。
结论：在 EBV 再激活时，评估血清蛋白电泳和免疫固定。
结论：同种异体 SCT 后 EBV 再激活时，γ-峰的总发生率为 65.3%（49 例患者中的 32 例），在 28 例可评估患者中，有 23 例（82%）发现单克隆丙种球蛋白病（MG）。
结论：所有发生 PTLD 的患者均出现 γ-峰，其中 5 例患者发现 MG。
结论：MG 与 EBV DNA-emia 一致，可能有助于识别同种异体 SCT 后进展为 PTLD。
