Clinical significance of Epstein-Barr Virus detection in the cerebrospinal fluid of patients who underwent hematopoietic stem cell transplantation.
10.3760/cma.j.issn.0253-2727.2023.09.006
- VernacularTitle:异基因造血干细胞移植患者脑脊液EB病毒检测的临床意义
- Author:
Yun HE
1
;
Rui MA
1
;
Hui Fang WANG
1
;
Xiao Dong MO
1
;
Yuan Yuan ZHANG
1
;
Meng LYU
1
;
Chen Hua YAN
1
;
Yu WANG
1
;
Xiao Hui ZHANG
1
;
Lan Ping XU
1
;
Kai Yan LIU
1
;
Xiao Jun SUN
1
;
Yu Qian HUANG
1
Author Information
1. Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.
- Publication Type:Journal Article
- Keywords:
Epstein-Barr virus;
Hematopoietic stem cell transplantation;
cerebrospinal fluid (CSF)
- MeSH:
Humans;
Male;
Female;
Adolescent;
Adult;
Middle Aged;
Herpesvirus 4, Human;
Epstein-Barr Virus Infections/complications*;
Rituximab/therapeutic use*;
Retrospective Studies;
Clinical Relevance;
Hematopoietic Stem Cell Transplantation/adverse effects*;
Lymphoproliferative Disorders/drug therapy*
- From:
Chinese Journal of Hematology
2023;44(9):737-741
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To analyze the detection rate, clinical significance, and prognosis of Epstein-Barr virus (EBV) in the cerebrospinal fluid (CSF) of patients following allogeneic hematopoietic stem cell transplantation. Methods: A retrospective analysis was performed on 1100 patients who underwent the CSF virus test after allogeneic hematopoietic stem cell transplantation in Peking University People's Hospital between January 2017 and June 2022. Among them, 19 patients were screened positive for EBV in their CSF, and their clinical characteristics, treatment, and prognosis were analyzed. Results: Among 19 patients with EBV-positive cerebrospinal fluid, 12 were male and 7 were female, with 5 patients aged <18 years and 12 aged ≥18 years, with a median age of 27 (5-58) years old. There were 7 cases of acute myeloid leukemia, 8 of acute lymphocytic leukemia, 2 of aplastic anemia, 1 of Hodgkin's lymphoma, and 1 of hemophagocytic syndrome. All 19 patients underwent haploid hematopoietic stem cell transplantation, including 1 secondary transplant. Nineteen patients had neurological symptoms (headache, dizziness, convulsions, or seizures), of which 13 had fever. Ten cases showed no abnormalities in cranial imaging examination. Among the 19 patients, 6 were diagnosed with EB virus-related central nervous system diseases, with a median diagnosis time of 50 (22-363) days after transplantation. In 9 (47.3%) patients, EBV was detected in their peripheral blood, and they were treated with intravenous infusion of rituximab (including two patients who underwent lumbar puncture and intrathecal injection of rituximab). After treatment, EBV was not detected in seven patients. Among the 19 patients, 2 died from EBV infection and 2 from other causes. Conclusion: In patients who exhibited central nervous system symptoms after allogeneic hematopoietic stem cell transplantation, EBV should be screened as a potential pathogen. EBV detected in the CSF may indicate an infection; however, it does not confirm the diagnosis.
