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Published on: September 7, 2022
A differential diagnosis method for systemic CAEBV and the prospect of EBV-related immune cell markers via flow
Jie Jin1, Xia Mao1, Donghua Zhang1
1Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Insights
Chronic active Epstein-Barr virus (CAEBV) infection poses diagnostic challenges due to its varied presentation. Flow cytometry offers promising advancements for earlier and more accurate diagnosis of this T-cell or NK-cell disorder.
Area of Science:
- Immunology
- Hematology
- Oncology
Background:
- Chronic active Epstein-Barr virus (CAEBV) infection, a systemic form (sCAEBV), is a WHO-defined EBV-related lymphoproliferative disorder.
- Clinical manifestations and prognoses of sCAEBV are heterogeneous, complicating differentiation from other EBV-positive T-cell and NK-cell proliferations.
- Current diagnostic methods rely on age, clinical signs, and cell lineage, leading to delays, misdiagnosis, and failure to identify high-risk cases early.
Purpose of the Study:
- To review recent advancements in the differential diagnosis of systemic CAEBV.
- To explore the diagnostic value and prospects of flow cytometry in identifying sCAEBV.
- To address the complexities and lack of systematic descriptions in current sCAEBV diagnostic procedures.
Main Methods:
- Summarization of recent progress in differential diagnosis of systemic CAEBV.
- Review of molecular biological and immunological techniques, including flow cytometry.
- Analysis of the utility of flow cytometry in diagnosing EBV-positive T-cell and NK-cell proliferations.
Main Results:
- Existing diagnostic approaches for sCAEBV are often insufficient, leading to diagnostic delays and misclassifications.
- Emerging molecular and immunological techniques, particularly flow cytometry, show potential for improved diagnostic accuracy.
- There is a need for a comprehensive review on the specific value of these newer techniques in sCAEBV diagnosis.
Conclusions:
- Early and accurate diagnosis of systemic CAEBV is crucial for improving patient outcomes, especially with hematopoietic stem cell transplantation.
- Flow cytometry presents a promising tool to enhance the understanding and diagnosis of EBV-positive T-cell and NK-cell proliferations.
- Further systematic evaluation of flow cytometry's role is needed to refine diagnostic strategies for sCAEBV.
Abstract:
Chronic active Epstein-Barr virus (CAEBV) infection of the T-cell or Natural killer (NK)-cell type, systemic form (systemic CAEBV or sCAEBV) was defined by the WHO in 2017 as an EBV-related lymphoproliferative disorder and is listed as an EBV-positive T-cell and NK-cell proliferation. The clinical manifestations and prognoses are heterogeneous. This makes systemic CAEBV indistinguishable from other EBV-positive T-cell and NK-cell proliferations. Early diagnosis of systemic CAEBV and early hematopoietic stem cell transplantation can improve patient prognosis. At present, the diagnosis of systemic CAEBV relies mainly on age, clinical manifestations, and cell lineage, incurring missed diagnosis, misdiagnosis, long diagnosis time, and inability to identify high-risk systemic CAEBV early. The diagnostic methods for systemic CAEBV are complicated and lack systematic description. The recent development of diagnostic procedures, including molecular biological and immunological techniques such as flow cytometry, has provided us with the ability to better understand the proliferation of other EBV-positive T cells and NK cells, but there is no definitive review of their value in diagnosing systemic CAEBV. This article summarizes the recent progress in systemic CAEBV differential diagnosis and the prospects of flow cytometry.
