Identifying predictive factors for posttransplant lymphoproliferative disease in pediatric solid organ transplant recipients with Epstein-Barr virus viremia

Lauren Weintraub, Chana Weiner, Tamir Miloh, Juli Tomaino, Umesh Joashi, Corinne Benchimol, James Strauchen, Michael Roth, Birte Wistinghausen

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Epstein-Barr virus (EBV) viremia (EV) in pediatric solid organ transplant (SOT) recipients is a significant risk factor for posttransplant lymphoproliferative disease (PTLD) but not all patients with EV develop PTLD. We identify predictive factors for PTLD in patients with EV. We conducted a retrospective chart review of all pediatric SOT recipients (0 to 21 y) at a single institution between 2001 and 2009. A total of 350 pediatric patients received a SOT and 90 (25.7%) developed EV. Of EV patients, 28 (31%) developed PTLD. The median age at transplant was 11.5 months in the PTLD group and 21.5 months in the EV-only group (P=0.003). Twenty-three (37%) EV-only patients had immunosuppression increased before EV, compared with 28 (100%) of PTLD patients (P<0.001). The median peak EBV level was 3212 EBV copies/105 lymphocytes for EV-only and 8392.5 EBV copies/105 lymphocytes for PTLD (P=0.005). All patients who developed PTLD had ≥1 clinical symptoms. Younger age at transplant, increased immunosuppression before EV, higher peak EBV level, and presence of clinical symptoms have predictive value in the development of PTLD in SOT patients with EV.

Original languageEnglish (US)
Pages (from-to)e481-e486
JournalJournal of Pediatric Hematology/Oncology
Volume36
Issue number8
DOIs
StatePublished - Nov 8 2014
Externally publishedYes

Keywords

  • Epstein-Barr virus
  • Immunosuppression
  • Posttransplant lymphoproliferative disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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