Pattern analysis of Epstein-Barr virus viremia and its significance in the evaluation of organ transplant patients suspected of having posttransplant lymphoproliferative disorders.

Abstract

To explore posttransplant lymphoproliferative disorder (PTLD) cases associated with Epstein-Barr virus (EBV). We retrospectively reviewed the EBV DNA quantitation data of 9,779 blood samples from 740 transplant patients and their associations with PTLD. EBV viremia occurred more frequently in patients with PTLD (85.4%) in comparison with patients without PTLD (38.3%; P < .0001). Patients with PTLD demonstrated significantly higher first positive results, higher peak levels, and a higher rate of increase in EBV viral load compared with patients without PTLD (P = .002, P < .0001, and P < .0001, respectively). However, in the multivariate analysis, only the peak level was associated with the development of PTLD. In particular, within hematopoietic stem cell recipients, the peak level able to diagnose PTLD was an area under the receiver operating characteristic curve of 0.806. We believe that pattern analysis of EBV DNA quantitation results could lead to the early diagnosis and timely treatment of PTLD.