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Updated guidelines for chronic active Epstein–Barr virus disease
Chronic active Epstein–Barr virus disease (CAEBV), formerly named chronic active Epstein–Barr virus infection, is characterized by systemic inflammation and clonal proliferation of Epstein–Barr virus (EBV)-infected T or NK cells. As CAEBV is a potentially life-threatening illness, appropriate diagno...
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Published in: | International journal of hematology 2023-11, Vol.118 (5), p.568-576 |
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container_title | International journal of hematology |
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creator | Kawada, Jun-ichi Ito, Yoshinori Ohshima, Koichi Yamada, Masaki Kataoka, Shinsuke Muramatsu, Hideki Sawada, Akihisa Wada, Taizo Imadome, Ken-Ichi Arai, Ayako Iwatsuki, Keiji Ohga, Shouichi Kimura, Hiroshi |
description | Chronic active Epstein–Barr virus disease (CAEBV), formerly named chronic active Epstein–Barr virus infection, is characterized by systemic inflammation and clonal proliferation of Epstein–Barr virus (EBV)-infected T or NK cells. As CAEBV is a potentially life-threatening illness, appropriate diagnosis and therapeutic interventions are necessary for favorable clinical outcomes. Substantial evidence regarding the pathogenesis and treatment of CAEBV has been accumulated since previous guidelines for the diagnosis of CAEBV were proposed. To reflect this evidence, we updated the guidelines for the diagnosis and treatment of CAEBV to improve clinical management of the disease. The details of the updated guidelines are presented in this report. Diagnosis of CAEBV now requires confirmation of a high copy number of EBV genome and EBV-infected T or NK cells. An EBV DNA load ≥ 10,000 IU/mL in whole blood is proposed as the diagnostic cutoff value for CAEBV in this updated guideline. A standard treatment approach for CAEBV has not been established, and hematopoietic stem cell transplantation (HSCT) is considered the only curative treatment. Chemotherapy can be administered to control disease activity before HSCT. |
doi_str_mv | 10.1007/s12185-023-03660-5 |
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As CAEBV is a potentially life-threatening illness, appropriate diagnosis and therapeutic interventions are necessary for favorable clinical outcomes. Substantial evidence regarding the pathogenesis and treatment of CAEBV has been accumulated since previous guidelines for the diagnosis of CAEBV were proposed. To reflect this evidence, we updated the guidelines for the diagnosis and treatment of CAEBV to improve clinical management of the disease. The details of the updated guidelines are presented in this report. Diagnosis of CAEBV now requires confirmation of a high copy number of EBV genome and EBV-infected T or NK cells. An EBV DNA load ≥ 10,000 IU/mL in whole blood is proposed as the diagnostic cutoff value for CAEBV in this updated guideline. A standard treatment approach for CAEBV has not been established, and hematopoietic stem cell transplantation (HSCT) is considered the only curative treatment. Chemotherapy can be administered to control disease activity before HSCT.</description><identifier>ISSN: 0925-5710</identifier><identifier>EISSN: 1865-3774</identifier><identifier>DOI: 10.1007/s12185-023-03660-5</identifier><identifier>PMID: 37728704</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Cell proliferation ; Chemotherapy ; Chronic infection ; Copy number ; Deoxyribonucleic acid ; Diagnosis ; Disease control ; DNA ; Epstein-Barr virus ; Genomes ; Guidelines ; Health services ; Hematology ; Hematopoietic stem cells ; Medicine ; Medicine & Public Health ; Oncology ; Pathogenesis ; Review ; Review Article ; Stem cell transplantation ; Stem cells ; Therapeutic applications ; Transplantation ; Viruses</subject><ispartof>International journal of hematology, 2023-11, Vol.118 (5), p.568-576</ispartof><rights>The Author(s) 2023</rights><rights>The Author(s) 2023. 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subjects | Cell proliferation Chemotherapy Chronic infection Copy number Deoxyribonucleic acid Diagnosis Disease control DNA Epstein-Barr virus Genomes Guidelines Health services Hematology Hematopoietic stem cells Medicine Medicine & Public Health Oncology Pathogenesis Review Review Article Stem cell transplantation Stem cells Therapeutic applications Transplantation Viruses |
title | Updated guidelines for chronic active Epstein–Barr virus disease |
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