北京大学医学部机构知识库
Advanced  
IR@PKUHSC  > 北京大学第二临床医学院  > 血液科  > 期刊论文
学科主题: 临床医学
题名:
Molecular monitoring and stepwise preemptive therapy for Epstein-Barr virus viremia after allogeneic stem cell transplantation
作者: Liu, Qifa1; Xuan, Li1; Liu, Hui1; Huang, Fen1; Zhou, Hongsheng1; Fan, Zhiping1; Zhao, Ke1; Wu, Meiqing1; Xu, Lanping2; Zhai, Xiao1; Zhang, Fuhua1; Liu, Can1; Sun, Jing1; Huang, Xiaojun2
刊名: AMERICAN JOURNAL OF HEMATOLOGY
发表日期: 2013-07-01
DOI: 10.1002/ajh.23452
卷: 88, 期:7, 页:550-555
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Hematology
研究领域[WOS]: Hematology
关键词[WOS]: POSTTRANSPLANT LYMPHOPROLIFERATIVE DISEASE ; POLYMERASE-CHAIN-REACTION ; VERSUS-HOST-DISEASE ; HIGH-RISK PATIENTS ; VIRAL LOAD ; HEMATOLOGICAL MALIGNANCIES ; EBV REACTIVATION ; DISORDERS ; RITUXIMAB ; RECIPIENTS
英文摘要:

The optimal preemptive therapy for Epstein-Barr virus (EBV)-associated diseases remains under discussion. We developed a stepwise preemptive therapy (antiviral agents and reduction of immunosuppressants [RI] followed by rituximab) for EBV viremia, based on duration of EBV viremia and changes of viral loads. The blood EBV-DNA loads were regularly monitored by quantitative real-time polymerase chain reaction in 251 recipients undergoing allogeneic stem cell transplantation. The 3-year cumulative incidence of EBV viremia and EBV-associated diseases were 31.1%+/- 3.1% and 15.6%+/- 2.5%, which rose steeply with greater numbers of major risk factors. Of the 64 patients undergoing first-step preemption, 24 achieved complete response (CR) and 40 showed no response, including 25 progressing to EBV-associated diseases. The effective rates of antiviral agents and RI plus antiviral agents were 2/16 and 22/48 (P=0.017). Fourteen achieved CR and one progressed to lymphoproliferative disease in the 15 patients undergoing rituximab preemption. Of the 26 patients progressing to EBV-associated diseases during preemptive therapy, 20 obtained CR in the 23 cases with rituximab-based treatments. The preemptive efficacy of RI plus antiviral agents was correlated with the numbers of major risk factors (rs=-0.298; P=0.04). B-cell reconstitution was significantly delayed for at least 6 months in patients with rituximab preemption. The risk of herpesvirus infection was similar in patients who showed effective progress to first-step and rituximab preemption (P=0.094). RI plus antiviral agents could be given priority to low-risk patients, whereas more frequent monitoring of blood EBV-DNA and earlier preemptive rituximab should be advocated in high-risk patients. Am. J. Hematol. 88:550-555, 2013. (c) 2013 Wiley Periodicals, Inc.

语种: 英语
所属项目编号: 2011AA020105 ; 201202017 ; 81000231 ; 81270647 ; 81200388 ; 30971300 ; 2009A030200007 ; 2012B031800403 ; A2010010 ; 10451008004004158
项目资助者: National High Technology Research and Development Program of China (863 Program) ; National Public Health Grand Research Foundation ; National Natural Science Foundation of China ; Science and Technology Project of Guangdong Province of China ; Medical Scientific Research Foundation of Guangdong Province ; Guangdong Natural Science Foundation
WOS记录号: WOS:000320662200003
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/66884
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

Files in This Item:

There are no files associated with this item.


作者单位: 1.Southern Med Univ, Nanfang Hosp, Dept Hematol, Guangzhou 510515, Guangdong, Peoples R China
2.Peking Univ Peoples Hosp, Inst Hematol, Beijing 100044, Peoples R China

Recommended Citation:
Liu, Qifa,Xuan, Li,Liu, Hui,et al. Molecular monitoring and stepwise preemptive therapy for Epstein-Barr virus viremia after allogeneic stem cell transplantation[J]. AMERICAN JOURNAL OF HEMATOLOGY,2013,88(7):550-555.
Service
Recommend this item
Sava as my favorate item
Show this item's statistics
Export Endnote File
Google Scholar
Similar articles in Google Scholar
[Liu, Qifa]'s Articles
[Xuan, Li]'s Articles
[Liu, Hui]'s Articles
CSDL cross search
Similar articles in CSDL Cross Search
[Liu, Qifa]‘s Articles
[Xuan, Li]‘s Articles
[Liu, Hui]‘s Articles
Related Copyright Policies
Null
Social Bookmarking
Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit

Items in IR are protected by copyright, with all rights reserved, unless otherwise indicated.

 

 

Valid XHTML 1.0!
Copyright © 2007-2017  北京大学医学部 - Feedback
Powered by CSpace