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High incidence but low mortality of EBV-reactivation and PTLD after alloHCT using ATG and PTCy for GVHD prophylaxis.
- Source :
-
Leukemia & lymphoma [Leuk Lymphoma] 2020 Dec; Vol. 61 (13), pp. 3198-3208. Date of Electronic Publication: 2020 Jul 25. - Publication Year :
- 2020
-
Abstract
- We explore risk factors and impacts of post-transplant EBV-Reactivation (EBV-R) and PTLD in 270 patients that underwent RIC alloHCT using ATG-PTCy and cyclosporine for GVHD prophylaxis. Twenty-five (12%) patients had probable ( n = 7) or proven ( n = 18) PTLD. Patients were managed with reduction of immunosuppression and 22 with weekly rituximab (375 mg/m <superscript>2</superscript> IV). ORR was 84%; 8 (32%) recipients died, and one-year OS and NRM of patients with PTLD was 59.7% and 37%, respectively. One hundred seventy-two (63.7%) recipients had EBV-R. One-year OS and RFS of patients with EBV-R were 68.2% and 60.6%, and of EBV-Negative patients were 62.1% and 50.1%, respectively. High incidence but low mortality of EBV-R and PTLD was documented. EBV-R induced a protective effect on RFS in multivariable analysis (HR 0.91, p = .011). Therefore, EBV-R may have a protective effect on RFS in this setting. Further research is necessary to evaluate the interplay of EBV-R, immune reconstitution, and post-transplant outcomes.
- Subjects :
- Herpesvirus 4, Human
Humans
Incidence
Retrospective Studies
Epstein-Barr Virus Infections epidemiology
Epstein-Barr Virus Infections prevention & control
Graft vs Host Disease epidemiology
Graft vs Host Disease etiology
Graft vs Host Disease prevention & control
Hematopoietic Stem Cell Transplantation adverse effects
Lymphoproliferative Disorders diagnosis
Lymphoproliferative Disorders epidemiology
Lymphoproliferative Disorders etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1029-2403
- Volume :
- 61
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- Leukemia & lymphoma
- Publication Type :
- Academic Journal
- Accession number :
- 32715815
- Full Text :
- https://doi.org/10.1080/10428194.2020.1797010