Characterization of Epstein-Barr virus-infected B cells in patients with posttransplantation lymphoproliferative disease: Disappearance after rituximab therapy does not predict clinical response

Jie Yang, Qian Tao, Ian W. Flinn, Paul G. Murray, Linda E. Post, Hong Ma, Steven Piantadosi, Michael A. Caligiuri, Richard F Ambinder

Research output: Contribution to journalArticle

Abstract

Post-transplantation lymphoproliferative disease (PTLD) is associated with Epstein-Barr virus (EBV). Quantitative and qualitative differences in EBV in peripheral blood mononuclear cells (PBMCs) of PTLD patients and healthy controls were characterized. A quantitative competitive polymerase chain reaction (QC-PCR) technique confirmed previous reports that EBV load in PBMCs is increased in patients with PTLD in comparison with healthy seropositive controls (18 539 vs 335 per 106 PBMCs, P = .0002). The average frequency of EBV-infected cells was also increased (271 vs 9 per 106 PBMCs, P = .008). The distribution in numbers of viral genome copies per cell was assessed by means of QC-PCR at dilutions of PBMCs. There was no difference between PTLD patients and healthy controls. Similarly, no differences in the patterns of viral gene expression were detected between patients and controls. Finally, the impact of therapy on viral load was analyzed. Patients with a past history of PTLD who were disease-free (after chemotherapy or withdrawal of immunosuppression) at the time of testing showed viral loads that overlapped with those of healthy seropositive controls. Patients treated with rituximab showed an almost immediate and dramatic decline in viral loads. This decline occurred even in patients whose PTLD progressed during therapy. These results suggest that the increased EBV load in PBMCs of PTLD patients can be accounted for by an increase in the number of infected B cells In the blood. However, in terms of viral copy number per cell and pattern of viral gene expression, these B cells are similar to those found in healthy controls. Disappearance of viral load with rituximab therapy confirms the localization of viral genomes in PBMCs to B cells. However, the lack of relationship between the change in viral load and clinical response highlights the difference between EBV-infected PBMCs and neoplastic cells in PTLD.

Original languageEnglish (US)
Pages (from-to)4055-4063
Number of pages9
JournalBlood
Volume96
Issue number13
StatePublished - 2000

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Human Herpesvirus 4
Viruses
Blood
B-Lymphocytes
Blood Cells
Cells
Viral Load
Transplantation
Therapeutics
Viral Genes
Viral Genome
Polymerase chain reaction
Cell Transplantation
Gene expression
Genes
Gene Expression
Rituximab
Polymerase Chain Reaction
Chemotherapy
Immunosuppression

ASJC Scopus subject areas

  • Hematology

Cite this

Characterization of Epstein-Barr virus-infected B cells in patients with posttransplantation lymphoproliferative disease : Disappearance after rituximab therapy does not predict clinical response. / Yang, Jie; Tao, Qian; Flinn, Ian W.; Murray, Paul G.; Post, Linda E.; Ma, Hong; Piantadosi, Steven; Caligiuri, Michael A.; Ambinder, Richard F.

In: Blood, Vol. 96, No. 13, 2000, p. 4055-4063.

Research output: Contribution to journalArticle

Yang, Jie ; Tao, Qian ; Flinn, Ian W. ; Murray, Paul G. ; Post, Linda E. ; Ma, Hong ; Piantadosi, Steven ; Caligiuri, Michael A. ; Ambinder, Richard F. / Characterization of Epstein-Barr virus-infected B cells in patients with posttransplantation lymphoproliferative disease : Disappearance after rituximab therapy does not predict clinical response. In: Blood. 2000 ; Vol. 96, No. 13. pp. 4055-4063.
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abstract = "Post-transplantation lymphoproliferative disease (PTLD) is associated with Epstein-Barr virus (EBV). Quantitative and qualitative differences in EBV in peripheral blood mononuclear cells (PBMCs) of PTLD patients and healthy controls were characterized. A quantitative competitive polymerase chain reaction (QC-PCR) technique confirmed previous reports that EBV load in PBMCs is increased in patients with PTLD in comparison with healthy seropositive controls (18 539 vs 335 per 106 PBMCs, P = .0002). The average frequency of EBV-infected cells was also increased (271 vs 9 per 106 PBMCs, P = .008). The distribution in numbers of viral genome copies per cell was assessed by means of QC-PCR at dilutions of PBMCs. There was no difference between PTLD patients and healthy controls. Similarly, no differences in the patterns of viral gene expression were detected between patients and controls. Finally, the impact of therapy on viral load was analyzed. Patients with a past history of PTLD who were disease-free (after chemotherapy or withdrawal of immunosuppression) at the time of testing showed viral loads that overlapped with those of healthy seropositive controls. Patients treated with rituximab showed an almost immediate and dramatic decline in viral loads. This decline occurred even in patients whose PTLD progressed during therapy. These results suggest that the increased EBV load in PBMCs of PTLD patients can be accounted for by an increase in the number of infected B cells In the blood. However, in terms of viral copy number per cell and pattern of viral gene expression, these B cells are similar to those found in healthy controls. Disappearance of viral load with rituximab therapy confirms the localization of viral genomes in PBMCs to B cells. However, the lack of relationship between the change in viral load and clinical response highlights the difference between EBV-infected PBMCs and neoplastic cells in PTLD.",
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