血浆EB病毒DNA监测在儿童异基因造血干细胞移植后淋巴增殖性疾病中的临床意义OA

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.