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Clinical utility of plasma Epstein-Barr virus DNA monitoring in pediatric EpsteināBarr virus-associated hemophagocytic lymphohistiocytosis: a Chinese retrospective observational study
- Source :
- Italian Journal of Pediatrics, Vol 50, Iss 1, Pp 1-8 (2024)
- Publication Year :
- 2024
- Publisher :
- BMC, 2024.
-
Abstract
- Abstract Background Epstein-Barr virus DNA (EBV-DNA) is closely related to the pathogenesis and prognosis of EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH). The quantitative measurement of blood EBV-DNA is widely used in EBV-HLH, but there remains a lack of evidence to guide clinicians. Methods A retrospective analysis was conducted on clinical manifestations, laboratory tests, 310 blood EBV-DNA loads, and prognosis of 51 pediatric patients diagnosed with EBV-HLH. Receiver operating characteristic (ROC) curves were utilized to determine the optimal cutoff values of EBV-DNA for predicting mortality and evaluating the active status of EBV-HLH. Results EBV-positive- lymphoma-HLH had higher initial plasma EBV-DNA load(1.10 × 106copies/ml) compared to the EBV-HLH group (1.98 × 104 copies/ml) (P = 0.006), and experienced recurrently elevated plasma EBV-DNA levels during treatment. The optimal cut-off value of initial plasma EBV-DNA load in predicting mortality was 2.68 × 105 copies/ml, with a sensitivity of 88.57% and a specificity of 56.25%. For determining the active status of HLH, the optimal cutoff value of PBMC EBV-DNA load during treatment was 2.95 × 105 copies/ml, with a sensitivity of 69.14% and a specificity of 64.71%. The cut-off value of plasma EBV-DNA for determining active status was 1.32 × 103 copies/ml, with a sensitivity of 84.34%, and a specificity of 87.67%. Patients with higher PBMC and plasma EBV-DNA at initial and those with repeated elevated plasma EBV-DNA during treatment had worse prognoses (P
Details
- Language :
- English
- ISSN :
- 18247288
- Volume :
- 50
- Issue :
- 1
- Database :
- Directory of Open Access Journals
- Journal :
- Italian Journal of Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.f4ab6cac30fc42469acb97519c09d354
- Document Type :
- article
- Full Text :
- https://doi.org/10.1186/s13052-024-01689-8