Division of Clinical Laboratory, Tottori University Hospital, Yonago, Japan.
Division of Clinical Laboratory Medicine, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.
Viral Immunol. 2023 Oct;36(8):520-525. doi: 10.1089/vim.2023.0053. Epub 2023 Jul 13.
Although cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are considered latent viruses, their reactivation occurs in immunosuppressed conditions. We previously reported that CMV and EBV are reactivated in patients receiving immunosuppressive therapy and/or chemotherapy. This retrospective, single-center study aimed to determine the frequency of viral reactivation and clinical characteristics of patients with B cell lymphoma (B-ML) receiving chemotherapy. Twenty-four patients (mean age 73 years, range 40-87 years; male-to-female ratio, 15:9) with diffuse large B cell lymphoma ( = 15), follicular lymphoma ( = 8), or mantle cell lymphoma ( = 1) were enrolled. Serum CMV and EBV DNA levels were analyzed using quantitative real-time polymerase chain reaction in patients with B-ML receiving chemotherapy. We determined the cumulative reactivation of each virus and analyzed the relationship between viral reactivation and clinical characteristics. Three patients experienced relapse or refractory (R/R) disease and the others had lymphomas. The frequencies of CMV and EBV reactivations were 54.2% and 37.5%, respectively. CMV reactivation occurred significantly earlier during chemotherapy courses in R/R patients than in patients ( = 0.0038), while EBV reactivation was frequently found before treatment. Baseline serum levels of soluble interleukin-2 receptor were higher (4318.0 vs. 981.1 U/mL, = 0.010) and hemoglobin levels were lower (11.1 vs. 13.0 g/dL, = 0.0038) in patients with EBV reactivation than in those without reactivation. These findings were not observed in patients with CMV reactivation. CMV reactivation was associated with iatrogenic immunosuppression, whereas EBV reactivation was related to immunosuppression by lymphoma, indicating that the mechanisms of these viral reactivations differed.
虽然巨细胞病毒 (CMV) 和 Epstein-Barr 病毒 (EBV) 被认为是潜伏病毒，但它们会在免疫抑制的情况下重新激活。我们之前曾报道过，CMV 和 EBV 会在接受免疫抑制治疗和/或化疗的患者中重新激活。本回顾性单中心研究旨在确定接受化疗的 B 细胞淋巴瘤 (B-ML) 患者病毒重新激活的频率和临床特征。共纳入 24 例患者（平均年龄 73 岁，范围 40-87 岁；男/女比为 15:9），其中弥漫性大 B 细胞淋巴瘤（n=15）、滤泡性淋巴瘤（n=8）或套细胞淋巴瘤（n=1）。对接受化疗的 B-ML 患者进行血清 CMV 和 EBV DNA 水平的定量实时聚合酶链反应分析。我们确定了每种病毒的累积再激活率，并分析了病毒再激活与临床特征之间的关系。3 例患者发生复发或难治性（R/R）疾病，其余患者患有淋巴瘤。CMV 和 EBV 的再激活频率分别为 54.2%和 37.5%。R/R 患者的 CMV 再激活发生在化疗疗程中更早（=0.0038），而 EBV 再激活则在治疗前经常发生。发生 EBV 再激活的患者的基线血清可溶性白细胞介素-2 受体水平较高（4318.0 比 981.1 U/mL，=0.010），血红蛋白水平较低（11.1 比 13.0 g/dL，=0.0038）。在没有再激活的患者中未观察到这些发现。CMV 再激活与医源性免疫抑制有关，而 EBV 再激活与淋巴瘤引起的免疫抑制有关，这表明这些病毒再激活的机制不同。
