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Original Article
Dynamics of Epstein-Barr virus after cord blood transplantation: A nationwide survey in Japan
Akihisa Sawada1, Shuichi Taniguchi2, Satoshi Takahashi3, Masami Inoue1, Yasushi Onishi4, Masatsugu Tanaka5, Hideho Henzan6, Masayuki Kubo7, Aya Nishida2, Keisei Kawa1

1Department of Hematology/Oncology, Osaka Womenʼs and Childrenʼs Hospital, Izumi, Japan,

2Department of Hematology, Toranomon Hospital, Tokyo, Japan,

3Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan,

4Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan,

5Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan,

6Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan,

7Department of Respiratory Medicine, Allergology and Hematology, Nara Medical University Hospital, Kashihara, Japan

Keywords
Epstein-Barr virus, hemophagocytic lymphohistiocytosis, lymphoproliferative disease, post-transplant lymphoproliferative disease, cord blood transplantation
Submitted:July 8, 2020
Accepted:October 3, 2020
Published online:December 11, 2020

Abstract

Epstein-Barr virus (EBV) is a common virus that latently infects most adults and has a tropism to B lymphocytes. In 1988, two cases of EBV infection were reported to be eradicated by hematopoietic stem cell transplantation from an EBV-negative donor. However, the dynamics of EBV after cord blood transplantation (CBT), namely, the kinetics of anti-EBV antibodies, the incidence of negative/adverse seroconversion (from positive to negative), and the clinical course of re-infection (second primary infection) by EBV, have not yet been characterized in detail. Therefore, we performed a nationwide survey that focused on the dynamics of EBV after CBT 1 year or later after CBT. Negative seroconversion occurred in 23% of previously EBV-infected patients. The incidence of late-onset EBV-associated events was 1.9% (13/674) : 5 infectious mononucleosis, 2 hemophagocytic lymphohistiocytosis (HLH), and 6 remaining typical lymphoproliferative disease. HLH occurred in newly infected patients (primary or second primary) and also in those with reactivation and was fatal. The annual monitoring of anti-EBV antibody titers may facilitate the early detection of these late-onset EBV-associated events and treatment initiation before disease progression.

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Online ISSN:2432-7026