AIMS AND METHODS: This study assessed incidence, predictive factors, and outcome of Epstein-Barr virus (EBV) DNAemia in 100 recipients of allogeneic hematopoietic stem cell transplant. A total of 68 patients received anti-thymocyte globulin before unrelated grafts. RESULTS: Cumulative incidence of high-load EBV DNAemia defined by levels >10,000 copies/mL was 14% at 12 months. In multivariate analysis, a CD4+ T-lymphocyte count >50 μL at day +30 was the only factor significantly associated with a reduced risk of high-load EBV DNAemia. Thirteen of 16 patients with high viral loads were preemptively treated with rituximab and achieved EBV DNA negativity. Three patients had already developed post-transplant lymphoproliferative disorder (PTLD) at the time of detection of high EBV DNA loads, and they obtained complete response after rituximab infusions and chemotherapy. Patients with high EBV DNA load had a significantly higher transplant-related mortality (TRM) compared with patients with negative or low viral load (54% vs. 16%, P = 0.009) and a trend to lower overall survival (55% vs. 29%, P = 0.060). CONCLUSION: We conclude that CD4+ cell count at day +30 is a predictive factor for EBV DNAemia and may help identify patients requiring closer monitoring. Although only 3% of patients progressed to PTLD and were all successfully managed, EBV reactivation was associated with higher TRM, mainly because of infections.
AIMS AND METHODS: This study assessed incidence, predictive factors, and outcome of Epstein-Barr virus (EBV) DNAemia in 100 recipients of allogeneic hematopoietic stem cell transplant. A total of 68 patients received anti-thymocyte globulin before unrelated grafts. RESULTS: Cumulative incidence of high-load EBV DNAemia defined by levels >10,000 copies/mL was 14% at 12 months. In multivariate analysis, a CD4+ T-lymphocyte count >50 μL at day +30 was the only factor significantly associated with a reduced risk of high-load EBV DNAemia. Thirteen of 16 patients with high viral loads were preemptively treated with rituximab and achieved EBV DNA negativity. Three patients had already developed post-transplant lymphoproliferative disorder (PTLD) at the time of detection of high EBV DNA loads, and they obtained complete response after rituximab infusions and chemotherapy. Patients with high EBV DNA load had a significantly higher transplant-related mortality (TRM) compared with patients with negative or low viral load (54% vs. 16%, P = 0.009) and a trend to lower overall survival (55% vs. 29%, P = 0.060). CONCLUSION: We conclude that CD4+ cell count at day +30 is a predictive factor for EBV DNAemia and may help identify patients requiring closer monitoring. Although only 3% of patients progressed to PTLD and were all successfully managed, EBV reactivation was associated with higher TRM, mainly because of infections.
Authors: I García-Cadenas; N Castillo; R Martino; P Barba; A Esquirol; S Novelli; G Orti; A Garrido; S Saavedra; C Moreno; M Granell; J Briones; S Brunet; F Navarro; I Ruiz; N Rabella; D Valcárcel; J Sierra Journal: Bone Marrow Transplant Date: 2015-01-12 Impact factor: 5.483
Authors: Neval E Wareham; Amanda Mocroft; Henrik Sengeløv; Caspar Da Cunha-Bang; Finn Gustafsson; Carsten Heilmann; Martin Iversen; Nikolai S Kirkby; Allan Rasmussen; Søren Schwartz Sørensen; Jens D Lundgren Journal: J Cancer Res Clin Oncol Date: 2018-05-26 Impact factor: 4.553
Authors: Seung Beom Han; E Young Bae; Jae Wook Lee; Pil Sang Jang; Dong-Gun Lee; Nack-Gyun Chung; Dae Chul Jeong; Bin Cho; Soon Ju Lee; Jin Han Kang; Hack-Ki Kim Journal: Int J Hematol Date: 2014-07-01 Impact factor: 2.490
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