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Clinical value of plasma Epstein-Barr virus DNA monitoring in lymphoproliferative disorders after allogeneic hematopoietic stem cell transplantation in children
Zhi-Heng DING, Li-Li YANG, Qi-Hong LIN, Dong-Yan CHEN, Ming-Jing LUO, Chun-Jing WANG, Xiao-Hui ZHOU, Yue LI, Qian ZHANG, Yu ZHANG, Chun-Lan YANG, Fei-Qiu WEN, Si-Xi LIU
Chinese Journal of Contemporary Pediatrics ›› 2026, Vol. 28 ›› Issue (9) : 1106-1112.
PDF(2155 KB)
PDF(2155 KB)
Clinical value of plasma Epstein-Barr virus DNA monitoring in lymphoproliferative disorders after allogeneic hematopoietic stem cell transplantation in children
Objective To evaluate the diagnostic value of plasma Epstein-Barr virus (EBV) DNA load and the duration of EBV DNAemia for post-transplant lymphoproliferative disorders (PTLD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. Methods Clinical data of children who underwent allo-HSCT at Shenzhen Children's Hospital from January 2016 to December 2023 and had plasma EBV-DNA positivity after transplantation were retrospectively analyzed. According to the occurrence of PTLD, patients were divided into a PTLD group (n=53) and a non-PTLD group (n=376). Results A total of 429 children were included; 53 (12.4%) developed PTLD, with a median time to PTLD diagnosis of 85 days post‑transplant. Peak plasma EBV-DNA load and the duration of EBV DNAemia were both significantly higher in the PTLD group than in the non-PTLD group (both P<0.001). Receiver operating characteristic curve analysis for predicting PTLD showed that using 2 250 copies/mL as the cut-off for plasma EBV-DNA load yielded the highest Youden index (sensitivity 0.811; specificity 0.699), while using 12.5 days as the cut-off for the duration of EBV DNAemia yielded the highest Youden index (sensitivity 0.868; specificity 0.870). Conclusions Dynamic monitoring of plasma EBV-DNA load and the duration of EBV DNAemia helps predict the occurrence of PTLD and facilitates early intervention in children after allo-HSCT.
Post-transplant lymphoproliferative disorder / Epstein-Barr virus / Allogeneic hematopoietic stem cell transplantation / Child
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