EPSTEIN-BARR-VIRUS POLYMERASE-CHAIN-REACTION AND SEROLOGY IN PEDIATRIC POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER - 3-YEAR EXPERIENCE

To assess whether the semiquantitative peripheral blood Epstein-Barr v irus (EBV) polymerase chain reaction (PCR) test correlates with post-t ransplant lymphoproliferative disorder (LPD), we compiled the results of the test done over a 3-year period ending July 1997. Six hundred se venty-six tests were done on 185 patients. Four hundred-thirty tests ( 63%) were negative, 167 (25%) were weak positive, 67 (10%) were modera te positive, and 12 (2%) were strong positive. Twelve of the patients developed a lymphoproliferative disorder (LPD) during this time. The E BV PCR tests proximate to the diagnosis of LPD in the 12 patients with EBV-positive LPD were 6 strong positive, 5 moderate positive, 1 weak positive. No patient with LPD had a negative result at diagnosis. Stat ed another way, 6/12 (50%) of strong-positive PCR tests, 5/67 (7%) mod erate-positive tests, and 1/167 (.6%) of weak-positive tests correlate d with LPD. Serologic evaluation for EBV done on 7 patients at the tim e of LPD showed low serologic responses in 5 of the 7 patients. The EB V PCR temporally associated with the serology indicated moderate to la rge viral burdens. In each patient evaluated serially, the EBV PCR tes t rose before the diagnosis of LPD and fell with treatment for the dis order. In conclusion, the EBV PCR test may be used as an adjunct to th e diagnosis of patients with LPD and may be used to monitor response t o therapy for the disorder.