Quantitative monitoring of circulating epstein-barr virus DNA for predicting the development of posttransplantation lymphoproliferative disease

Epstein-Barr virus (EBV)-DNA was quantitatively measured to assess posttransplantation virus reactivation by realtime polymerase chain reaction (PCR). In the first retrospective analysis of a 7-year-old boy with lymphoproliferative disease (LPD) after an unrelated cord blood transplantation, serum EBV-DNA progressively increased to 4 × 10⁵ copies/mL. EBV load was then prospectively monitored in peripheral blood from posttransplantation patients. The second case was an 8 year-old boy with aplastic anemia who received a CD34⁺cell transplantation. This patient died of LPD with the progression of pulmonary nodules. EBV-DNA increased to 4 × 10⁴ copies/mL after the control of cytomegalovirus reactivation. On the other hand, EBV-DNA was undetectable (<200 copies/mL) in the series of all 58 samples from 10 patients who did not develop LPD after hematopoietic stem cell transplantation. Sequential monitoring of circulating EBV-DNA by quan-titative PCR may be a useful indicator for predicting the development of posttransplantation LPD.