Dynamics of Epstein-Barr virus after cord blood transplantation: A nationwide survey in Japan

• Published in: Blood cell therapy 2021-02, Vol.4 (1), p.9-14
• Main Authors: Sawada, Akihisa, Taniguchi, Shuichi, Takahashi, Satoshi, Inoue, Masami, Onishi, Yasushi, Tanaka, Masatsugu, Henzan, Hideho, Kubo, Masayuki, Nishida, Aya, Kawa, Keisei
• Format: Article
• Language: English
• ISSN: 2432-7026; 2432-7026
• DOI: 10.31547/bct-2020-010

Epstein-Barr virus (EBV) is a common virus that latently infects most adults and has a tropism to B lymphocytes. In 1988, two cases of EBV infection were reported to be eradicated by hematopoietic stem cell transplantation from an EBV-negative donor. However, the dynamics of EBV after cord blood transplantation (CBT), namely, the kinetics of anti-EBV antibodies, the incidence of negative/adverse seroconversion (from positive to negative), and the clinical course of re-infection (second primary infection) by EBV, have not yet been characterized in detail. Therefore, we performed a nationwide survey that focused on the dynamics of EBV after CBT 1 year or later after CBT. Negative seroconversion occurred in 23% of previously EBV-infected patients. The incidence of late-onset EBV-associated events was 1.9% (13/674): 5 infectious mononucleosis, 2 hemophagocytic lymphohistiocytosis (HLH), and 6 remaining typical lymphoproliferative disease. HLH occurred in newly infected patients (primary or second primary) and also in those with reactivation and was fatal. The annual monitoring of anti-EBV antibody titers may facilitate the early detection of these late-onset EBV-associated events and treatment initiation before disease progression.