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This prospective case-control study aims to evaluate the immune function and find PD-1 antibody efficacy predictors on Chronic Active Epstein-Barr Virus Infection and Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis by detecting lymphocyte subsets proportions in peripheral blood mononuclear cells and the positive proportion of PD-1, PD-L1 and other indicators in each lymphocyte subsets in healthy people and patients using flow cytometry before and after the initial PD-1 therapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Healthy Control | Healthy male or female aged 2-80 years with negative EBV-DNA quantitative test results within the last week. |
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| CAEBV or EBV-HLH Patients | Patients aged 2-80 years who fulfilled the diagnostic criteria for CAEBV or EBV-HLH. The diagnostic criteria for CAEBV as defined in the recently revised World Health Organization classification include persistent IM-like symptoms for more than three months, increased EBV DNA (>10^2.5 copies/mg) in peripheral blood, histological evidence of organ disease, and EBV RNA or viral protein in affected tissues. Patients diagnosed with EBV-HLH must meet five of the following eight HLH-2004 diagnostic criteria:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No intervention | Other | No intervention |
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| Measure | Description | Time Frame |
|---|---|---|
| EBV-DNA | Treatment effectiveness is defined: EBV-DNA copies/ml in peripheral blood turns negative, and the involved tissues (such as lymph nodes, bone marrow, skin, etc.) are negative in EBER test or the EBV copy number has decreased by more than 2 orders of magnitude, but it is still positive. | Change from before and 2 weeks after initiating PD-1 blockade therapy. |
| Measure | Description | Time Frame |
|---|---|---|
| CAEBV Evaluation of treatment response | Complete response (CR) was defined as EBV-DNA copy number below the lower limit of detection (<5.0×10^2 copies/ml) for at least 4 weeks. Partial response (PR) was defined as ≤ 1/100 reduction in EBV-DNA copy number, and the CR criterion was not met. Failure to achieve at least PR was defined as no response (NR). Besides, the main clinical manifestation of CAEBV, including fever, asthenia, liver damage (elevation of ALT and AST), skin rash, cytopenia and lymphadenopathy was also evaluated. |
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Inclusion Criteria:
Exclusion Criteria:
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Healthy people and patients with CAEBV or secondary EBV-HLH.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zhao Wang | Contact | 86-010-63139862 | zhaowww263@yahoo.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Friendship Hospital, Capital Medical University | Recruiting | Beijing | Beijing Municipality | 100050 | China |
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10ml venous blood was extracted and peripheral blood mononuclear cells were extracted for flow cytometry detection. The detection contents included the frequencies of lymphocyte subsets, the positive proportion of PD-1/PD-L1 and EBER positive proportion in each subgroup.
| Change from before and 2 weeks after initiating PD-1 blockade therapy. |
| EBV-HLH Evaluation of treatment response | A complete response (CR) was defined as normalization of all of the quantifiable symptoms and laboratory markers of HLH, including levels of sCD25, ferritin, and triglyceride; hemoglobin; neutrophil counts; platelet counts; and alanine aminotransferase (ALT). A partial response (PR) was defined as at least a 25% improvement in 2 or more quantifiable symptoms and laboratory markers as follows: sCD25 response was>1.5-fold decreased; ferritin and triglyceride decreased at least 25%; for patients with an initial neutrophil count of<0.5 ×10^9/L, a response was defined as an increase by at least 100% to>0.5×10^9/L; for patients with a neutrophil count of 0.5 to 2.0× 109/L, an increase by at least 100% to >2.0 × 10^9/L was considered a response; and for patients with ALT >400 U/L, response was defined as an ALT decrease of at least 50%. | Change from before and 2 weeks after initiating PD-1 blockade therapy. |
| Progression Free Survival | from date of inclusion to date of progression, relapse, or death from any cause | 6 months |