A Study of Flow Sorting Lymphocyte Subsets to Detect Epstein-Barr Virus Reactivation in Patients with Hematological Malignancies.
10.19746/j.cnki.issn.1009-2137.2025.05.034
- Author:
Hui-Ying LI
1
;
Shen-Hao LIU
1
;
Fang-Tong LIU
1
;
Kai-Wen TAN
1
;
Zi-Hao WANG
1
;
Han-Yu CAO
1
;
Si-Man HUANG
1
;
Chao-Ling WAN
1
;
Hai-Ping DAI
1
;
Sheng-Li XUE
1
;
Lian BAI
2
Author Information
1. The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, Jiangsu Province, China.
2. Department of Hematology, Canglang Hospital of Suzhou, Suzhou 215007, Jiangsu Province, China.
- Publication Type:Journal Article
- Keywords:
Epstein-Barr virus;
reactivation;
lymphocyte subsets;
hematological malignancy;
rituximab
- MeSH:
Humans;
Hematologic Neoplasms/virology*;
Herpesvirus 4, Human/physiology*;
Epstein-Barr Virus Infections;
Hematopoietic Stem Cell Transplantation;
Virus Activation;
Lymphocyte Subsets/virology*;
Flow Cytometry;
Killer Cells, Natural/virology*;
Male;
Female;
B-Lymphocytes/virology*;
Viral Load;
Adult;
T-Lymphocytes/virology*;
Middle Aged
- From:
Journal of Experimental Hematology
2025;33(5):1468-1475
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To analyze the Epstein-Barr virus (EBV) load in different lymphocyte subsets, as well as clinical characteristics and outcomes in patients with hematologic malignancies experiencing EBV reactivation.
METHODS:Peripheral blood samples from patients were collected. B, T, and NK cells were isolated sorting with magnetic beads by flow cytometry. The EBV load in each subset was quantitated by real-time quantitative polymerase chain reaction (RT-qPCR). Clinical data were colleted from electronic medical records. Survival status was followed up through outpatient visits and telephone calls. Statistical analyses were performed using SPSS 25.0.
RESULTS:A total of 39 patients with hematologic malignancies were included, among whom 35 patients had undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT). The median time to EBV reactivation was 4.8 months (range: 1.7-57.1 months) after allo-HSCT. EBV was detected in B, T, and NK cells in 20 patients, in B and T cells in 11 patients, and only in B cells in 4 patients. In the 35 patients, the median EBV load in B cells was 2.19×104 copies/ml, significantly higher than that in T cells (4.00×103 copies/ml, P <0.01) and NK cells (2.85×102 copies/ml, P <0.01). Rituximab (RTX) was administered for 32 patients, resulting in EBV negativity in 32 patients with a median time of 8 days (range: 2-39 days). Post-treatment analysis of 13 patients showed EBV were all negative in B, T, and NK cells. In the four non-transplant patients, the median time to EBV reactivation was 35 days (range: 1-328 days) after diagnosis of the primary disease. EBV was detected in one or two subsets of B, T, or NK cells, but not simultaneously in all three subsets. These patients received a combination chemotherapy targeting at the primary disease, with 3 patients achieving EBV negativity, and the median time to be negative was 40 days (range: 13-75 days).
CONCLUSION:In hematologic malignancy patients after allo-HSCT, EBV reactivation commonly involves B, T, and NK cells, with a significantly higher viral load in B cells compared to T and NK cells. Rituximab is effective for EBV clearance. In non-transplant patients, EBV reactivation is restricted to one or two lymphocyte subsets, and clearance is slower, highlighting the need for prompt anti-tumor therapy.
