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Clinical significance and different strategies for re-elevation of plasma EBV-DNA during treatment in pediatric EBV-associated hemophagocytic lymphohistiocytosis
Zhang, Wenzhi; Peng, Yun; Qiu, Yining; Cheng, Li; Yin, Yuhong; Li, Ying; Zhao, Lizhen; Wu, Xiaoyan.
Afiliação
  • Zhang, Wenzhi; Huazhong University of Science and Technology. Tongji Medical College. Union Hospital, Department of Pediatrics. Wuhan. CN
  • Peng, Yun; Huazhong University of Science and Technology. Tongji Medical College. Union Hospital, Department of Pediatrics. Wuhan. CN
  • Qiu, Yining; Huazhong University of Science and Technology. Tongji Medical College. Union Hospital, Department of Pediatrics. Wuhan. CN
  • Cheng, Li; Huazhong University of Science and Technology. Tongji Medical College. Union Hospital, Department of Pediatrics. Wuhan. CN
  • Yin, Yuhong; Huazhong University of Science and Technology. Tongji Medical College. Union Hospital, Department of Pediatrics. Wuhan. CN
  • Li, Ying; Huazhong University of Science and Technology. Tongji Medical College. Union Hospital, Department of Pediatrics. Wuhan. CN
  • Zhao, Lizhen; Huazhong University of Science and Technology. Tongji Medical College. Union Hospital, Department of Pediatrics. Wuhan. CN
  • Wu, Xiaoyan; Huazhong University of Science and Technology. Tongji Medical College. Union Hospital, Department of Pediatrics. Wuhan. CN
J. pediatr. (Rio J.) ; J. pediatr. (Rio J.);100(5): 505-511, Sept.-Oct. 2024. tab, graf
Article em En | LILACS-Express | LILACS | ID: biblio-1575176
Biblioteca responsável: BR1.1
ABSTRACT
Abstract Objective Monitoring the disease status of Epstein-Barr virus (EBV)-related hemophagocytic lymphohistiocytosis (HLH) patients is crucial. This study aimed to investigate the different strategies and outcomes of patients with EBV-HLH and re-elevated EBV-DNA. Method A retrospective analysis was conducted on 20 patients diagnosed with EBV-HLH. Clinical features, laboratory tests, treatments, plasma EBV-DNA levels, and outcomes were assessed. Three cases were highlighted for detailed analysis. Results Nine of the 20 patients had a re-elevation of EBV-DNA during treatment, and 55.5 % (5/9) experienced relapses. Patients with persistently positive plasma EBV-DNA (n = 4) and those with re-elevated EBV-DNA after conversion (n = 9) showed a significantly higher relapse rate compared to those with persistently negative EBV-HLH (n = 7) (p < 0.05). Among the highlighted cases, Case 1 exhibited plasma EBV-DNA re-elevation after four weeks of treatment without relapse, maintaining stability with the original treatment regimen, and eventually, his plasma EBV-DNA turned negative. In Case 2, plasma EBV-DNA was elevated again with a recurrence of HLH after L-DEP. Consequently, she underwent allogeneic hematopoietic stem cell transplantation and eventually achieved complete remission (CR) with negative plasma EBV-DNA. Case 3 experienced plasma EBV-DNA re-elevation after L-DEP but remained in CR, discontinuing chemotherapy without relapse. Conclusion The re-elevation of plasma EBV-DNA during EBV-HLH treatment poses challenges in determining disease status and treatment strategies. Optimal management decisions require a combination of the level of elevated EBV-DNA, the intensity of hyperinflammation, and the patient's immune function.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Idioma: En Revista: J. pediatr. (Rio J.) Assunto da revista: PEDIATRIA Ano de publicação: 2024 Tipo de documento: Article / Project document País de afiliação: China País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Idioma: En Revista: J. pediatr. (Rio J.) Assunto da revista: PEDIATRIA Ano de publicação: 2024 Tipo de documento: Article / Project document País de afiliação: China País de publicação: Brasil