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Article: Valganciclovir suppressed Epstein Barr virus reactivation during immunosuppression with alemtuzumab

TitleValganciclovir suppressed Epstein Barr virus reactivation during immunosuppression with alemtuzumab
Authors
KeywordsProphylaxis
Epstein Barr virus
Cytomegalovirus
Alemtuzumab
Valganciclovir
Issue Date2014
Citation
Journal of Clinical Virology, 2014, v. 59, n. 4, p. 255-258 How to Cite?
AbstractBackground: Reactivation of latent herpes viruses occurs with immunosuppression. Alemtuzumab is an antibody targeting CD52, which is expressed on all B- and T-cells. Treatment with alemtuzumab leads to profound T-cell suppression, and reactivation of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) occurs. Valganciclovir is used as an anti-CMV prophylaxis during alemtuzumab therapy. Objective: To determine if EBV reactivation is decreased with valganciclovir prophylaxis. Study design: Plasma EBV DNA was serially quantified by quantitative polymerase chain reaction with a World Health Organization EBV standard in patients receiving alemtuzumab therapy with valganciclovir as anti-CMV prophylaxis. Results: Twenty-nine patients were studied. A total of 258 samples were quantified, at a median of 7 (3-25) specimens per patient. Twenty-four patients never had any quantifiable EBV DNA. Five patients (17%) developed EBV reactivation. Two patients had EBV reactivation at very low levels of about 103IU/mL, 3-4 logs lower than those typically found in post-transplant lymphoproliferative diseases. Three patients had EBV reactivation at higher levels of 104IU/mL, which only occurred after two courses of alemtuzumab were administered. EBV reactivation subsided spontaneously in four cases. One patient developed EBV-positive Hodgkin lymphoma, but he had also received previously another potent T-cell suppressing drug fludarabine. Conclusion: Valganciclovir suppressed EBV reactivation during alemtuzumab therapy. It might be a useful prophylaxis in immunocompromized patient populations at high risk of EBV reactivation. © 2014 Elsevier B.V.
Persistent Identifierhttp://hdl.handle.net/10722/199941
ISSN
2015 Impact Factor: 2.647
2015 SCImago Journal Rankings: 1.503
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorGill, Harinder-
dc.contributor.authorHwang, Yuyan-
dc.contributor.authorChan, Thomas S Y-
dc.contributor.authorPang, Annie-
dc.contributor.authorLeung, Anskar Y H-
dc.contributor.authorTse, Eric-
dc.contributor.authorKwong, Yoklam-
dc.date.accessioned2014-07-26T23:10:56Z-
dc.date.available2014-07-26T23:10:56Z-
dc.date.issued2014-
dc.identifier.citationJournal of Clinical Virology, 2014, v. 59, n. 4, p. 255-258-
dc.identifier.issn1386-6532-
dc.identifier.urihttp://hdl.handle.net/10722/199941-
dc.description.abstractBackground: Reactivation of latent herpes viruses occurs with immunosuppression. Alemtuzumab is an antibody targeting CD52, which is expressed on all B- and T-cells. Treatment with alemtuzumab leads to profound T-cell suppression, and reactivation of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) occurs. Valganciclovir is used as an anti-CMV prophylaxis during alemtuzumab therapy. Objective: To determine if EBV reactivation is decreased with valganciclovir prophylaxis. Study design: Plasma EBV DNA was serially quantified by quantitative polymerase chain reaction with a World Health Organization EBV standard in patients receiving alemtuzumab therapy with valganciclovir as anti-CMV prophylaxis. Results: Twenty-nine patients were studied. A total of 258 samples were quantified, at a median of 7 (3-25) specimens per patient. Twenty-four patients never had any quantifiable EBV DNA. Five patients (17%) developed EBV reactivation. Two patients had EBV reactivation at very low levels of about 103IU/mL, 3-4 logs lower than those typically found in post-transplant lymphoproliferative diseases. Three patients had EBV reactivation at higher levels of 104IU/mL, which only occurred after two courses of alemtuzumab were administered. EBV reactivation subsided spontaneously in four cases. One patient developed EBV-positive Hodgkin lymphoma, but he had also received previously another potent T-cell suppressing drug fludarabine. Conclusion: Valganciclovir suppressed EBV reactivation during alemtuzumab therapy. It might be a useful prophylaxis in immunocompromized patient populations at high risk of EBV reactivation. © 2014 Elsevier B.V.-
dc.languageeng-
dc.relation.ispartofJournal of Clinical Virology-
dc.subjectProphylaxis-
dc.subjectEpstein Barr virus-
dc.subjectCytomegalovirus-
dc.subjectAlemtuzumab-
dc.subjectValganciclovir-
dc.titleValganciclovir suppressed Epstein Barr virus reactivation during immunosuppression with alemtuzumab-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jcv.2014.01.005-
dc.identifier.pmid24507802-
dc.identifier.scopuseid_2-s2.0-84895925896-
dc.identifier.hkuros237427-
dc.identifier.volume59-
dc.identifier.issue4-
dc.identifier.spage255-
dc.identifier.epage258-
dc.identifier.eissn1873-5967-
dc.identifier.isiWOS:000333284900009-

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