Jan Styczynski1, Gloria Tridello2, Lidia Gil2, Per Ljungman2, Jennifer Hoek2, Simona Iacobelli2, Katherine N Ward2, Catherine Cordonnier2, Hermann Einsele2, Gerard Socie2, Noel Milpied2, Hendrik Veelken2, Patrice Chevallier2, Ibrahim Yakoub-Agha2, Johan Maertens2, Didier Blaise2, Jan Cornelissen2, Mauricette Michallet2, Etienne Daguindau2, Eefke Petersen2, Jakob Passweg2, Hildegard Greinix2, Rafael F Duarte2, Nicolaus Kröger2, Peter Dreger2, Mohamad Mohty2, Arnon Nagler2, Simone Cesaro2. 1. Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel. jstyczynski@cm.umk.pl. 2. Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Abstract
PURPOSE: We investigated the effect of Epstein-Barr virus (EBV) serostatus on the overall outcome of allogeneic hematopoietic stem-cell transplantation (allo-HSCT). PATIENTS AND METHODS: The study included 11,364 patients who underwent allogeneic peripheral-blood or bone marrow transplantation for acute leukemia between 1997 and 2012. We analyzed the impact of donor and recipient EBV serologic status on overall survival, relapse-free survival, relapse incidence, nonrelapse mortality, and incidence of graft-versus-host disease (GVHD) after allo-HSCT. RESULTS: Patients receiving grafts from EBV-seropositive donors had the same overall survival as patients who received grafts from EBV-seronegative donors (hazard ratio [HR], 1.05; 95% CI, 0.97 to 1.12; P = .23). Seropositive donors also had no influence on relapse-free survival (HR, 1.04; 95% CI, 0.97 to 1.11; P = 0.31), relapse incidence (HR, 1.03; 95% CI, 0.94 to 1.12; P = .58), and nonrelapse mortality (HR, 1.05; 95% CI, 0.94 to 1.17; P = .37). However, in univariate analysis, recipients receiving grafts from seropositive donors had a higher risk of chronic GVHD than those with seronegative donors (40.8% v 31.0%, respectively; P < .001; HR, 1.42; 95% CI, 1.30 to 1.56). When adjusting for confounders, higher risk was identified for both acute and chronic GVHD. In seronegative patients with seropositive donors, the HR for chronic GVHD was 1.30 (95% CI, 1.06 to 1.59; P = .039). In seropositive patients with seropositive donors, the HR was 1.24 (95% CI, 1.07 to 1.45; P = .016) for acute GVHD and 1.43 (95% CI, 1.23 to 1.67; P < .001) for chronic GVHD. Seropositive patients with seronegative donors did not have an increased risk of GVHD. CONCLUSION: Our data suggest that donor EBV status significantly influences development of acute and chronic GVHD after allo-HSCT.
PURPOSE: We investigated the effect of Epstein-Barr virus (EBV) serostatus on the overall outcome of allogeneic hematopoietic stem-cell transplantation (allo-HSCT). PATIENTS AND METHODS: The study included 11,364 patients who underwent allogeneic peripheral-blood or bone marrow transplantation for acute leukemia between 1997 and 2012. We analyzed the impact of donor and recipient EBV serologic status on overall survival, relapse-free survival, relapse incidence, nonrelapse mortality, and incidence of graft-versus-host disease (GVHD) after allo-HSCT. RESULTS:Patients receiving grafts from EBV-seropositive donors had the same overall survival as patients who received grafts from EBV-seronegative donors (hazard ratio [HR], 1.05; 95% CI, 0.97 to 1.12; P = .23). Seropositive donors also had no influence on relapse-free survival (HR, 1.04; 95% CI, 0.97 to 1.11; P = 0.31), relapse incidence (HR, 1.03; 95% CI, 0.94 to 1.12; P = .58), and nonrelapse mortality (HR, 1.05; 95% CI, 0.94 to 1.17; P = .37). However, in univariate analysis, recipients receiving grafts from seropositive donors had a higher risk of chronic GVHD than those with seronegative donors (40.8% v 31.0%, respectively; P < .001; HR, 1.42; 95% CI, 1.30 to 1.56). When adjusting for confounders, higher risk was identified for both acute and chronic GVHD. In seronegative patients with seropositive donors, the HR for chronic GVHD was 1.30 (95% CI, 1.06 to 1.59; P = .039). In seropositive patients with seropositive donors, the HR was 1.24 (95% CI, 1.07 to 1.45; P = .016) for acute GVHD and 1.43 (95% CI, 1.23 to 1.67; P < .001) for chronic GVHD. Seropositive patients with seronegative donors did not have an increased risk of GVHD. CONCLUSION: Our data suggest that donorEBV status significantly influences development of acute and chronic GVHD after allo-HSCT.
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