ArticleVirology journal2026
EBV DNA load and cytokines guide risk-stratified treatment in pediatric EBV-associated hemophagocytic lymphohistiocytosis.
Article in Virology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOur study aims to investigate the dynamic changes in plasma/serum EBV-DNA levels and the cytokines IL-10 and IFN-γ during early chemotherapy. This will help predict refractory EBV-HLH and guide more personalized treatment strategies.
methodsThis retrospective, single-centre cohort investigation included 117 EBV-HLH; out of these, 48 had comprehensive paired data before and after induction treatment. The median age was 3.86 years. Patients were classified based on pre-treatment plasma/serum EBV-DNA levels into high-load (≥ 5.51 × 10
resultsPatients with high plasma/serum EBV-DNA loads demonstrated a higher prevalence of DIC (20.00% vs. 3.51%, OR = 7.15) at baseline. After a two-week treatment period, the decline in EBV-DNA was strongly correlated with reductions in IFN-γ (r = 0.443, P = 0.002) and IL-10 (r = 0.540, P < 0.001). Interestingly, in this study, we also found that children with a double-positive status (EBV+/IFN-γ + or EBV+/IL-10+) did not have the worst prognosis two weeks after initial treatment. However, children with HLH who are EBV (+) but cytokine (-) have a lower proportion of partial responses. Similarly, most children with HLH who are plasma or serum EBV-negative but cytokine-positive are also in the non-response period.
conclusionsIn the early stages of treatment, monitoring plasma/serum free EBV-DNA, as well as IL-10 or IFN-γ indicators, and stratifying patients is an effective method to identify children with EBV-HLH who are prone to refractory disease. This approach is of great significance for guiding their subsequent treatment.
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