Response to rituximab-based therapy and risk factor analysis in epstein barr virus-related lymphoproliferative disorder after hematopoietic stem cell transplant in children and adults: A study from the infectious diseases working party of the european group for blood and marrow transplantation

Jan Styczynski, Lidia Gil, Gloria Tridello, Per Ljungman, J. Peter Donnelly, Walter Van Der Velden, Hamdy Omar, Rodrigo Martino, Constantijn Halkes, Maura Faraci, Koen Theunissen, Krzysztof Kalwak, Petr Hubacek, Simona Sica, Chiara Nozzoli, Franca Fagioli, Susanne Matthes, Miguel A. Diaz, Maddalena Migliavacca, Adriana BalduzziAgnieszka Tomaszewska, Rafael De La Camara, Anja Van Biezen, Jennifer Hoek, Simona Iacobelli, Hermann Einsele, Simone Cesaro

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Abstract

Background. The objective of this analysis was to investigate prognostic factors that influence the outcome of Epstein-Barr virus (EBV)-related posttransplant lymphoproliferative disorder (PTLD) after a rituximab-based treatment in the allogeneic hematopoietic stem cell transplant (HSCT) setting.Methods. A total of 4466 allogeneic HSCTs performed between 1999 and 2011 in 19 European Group for Blood and Marrow Transplantation centers were retrospectively analyzed for PTLD, either biopsy-proven or probable disease.Results. One hundred forty-four cases of PTLD were identified, indicating an overall EBV-related PTLD frequency of 3.22%, ranging from 1.16% for matched-family donor, 2.86% for mismatched family donor, 3.97% in matched unrelated donors, and 11.24% in mismatched unrelated donor recipients. In total, 69.4% patients survived PTLD. Multivariable analysis showed that a poor response of PTLD to rituximab was associated with an age ≥30 years, involvement of extralymphoid tissue, acute GVHD, and a lack of reduction of immunosuppression upon PTLD diagnosis. In the prognostic model, the PTLD mortality increased with the increasing number of factors: 0-1, 2, or 3 factors being associated with mortality of 7%, 37%, and 72%, respectively (P

Original languageEnglish
Pages (from-to)794-802
Number of pages9
JournalClinical Infectious Diseases
Volume57
Issue number6
DOIs
Publication statusPublished - Sep 15 2013

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Lymphoproliferative Disorders
Blood Group Antigens
Hematopoietic Stem Cells
Human Herpesvirus 4
Statistical Factor Analysis
Communicable Diseases
Transplantation
Bone Marrow
Transplants
Unrelated Donors
Therapeutics
Tissue Donors
Mortality
Rituximab
Immunosuppression
Biopsy

Keywords

  • Epstein-Barr virus
  • hematopoietic stem cell transplantation
  • post-transplant lymphoproliferative disorder
  • prognostic model
  • risk factors

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Response to rituximab-based therapy and risk factor analysis in epstein barr virus-related lymphoproliferative disorder after hematopoietic stem cell transplant in children and adults : A study from the infectious diseases working party of the european group for blood and marrow transplantation. / Styczynski, Jan; Gil, Lidia; Tridello, Gloria; Ljungman, Per; Donnelly, J. Peter; Van Der Velden, Walter; Omar, Hamdy; Martino, Rodrigo; Halkes, Constantijn; Faraci, Maura; Theunissen, Koen; Kalwak, Krzysztof; Hubacek, Petr; Sica, Simona; Nozzoli, Chiara; Fagioli, Franca; Matthes, Susanne; Diaz, Miguel A.; Migliavacca, Maddalena; Balduzzi, Adriana; Tomaszewska, Agnieszka; Camara, Rafael De La; Van Biezen, Anja; Hoek, Jennifer; Iacobelli, Simona; Einsele, Hermann; Cesaro, Simone.

In: Clinical Infectious Diseases, Vol. 57, No. 6, 15.09.2013, p. 794-802.

Research output: Contribution to journalArticle

Styczynski, J, Gil, L, Tridello, G, Ljungman, P, Donnelly, JP, Van Der Velden, W, Omar, H, Martino, R, Halkes, C, Faraci, M, Theunissen, K, Kalwak, K, Hubacek, P, Sica, S, Nozzoli, C, Fagioli, F, Matthes, S, Diaz, MA, Migliavacca, M, Balduzzi, A, Tomaszewska, A, Camara, RDL, Van Biezen, A, Hoek, J, Iacobelli, S, Einsele, H & Cesaro, S 2013, 'Response to rituximab-based therapy and risk factor analysis in epstein barr virus-related lymphoproliferative disorder after hematopoietic stem cell transplant in children and adults: A study from the infectious diseases working party of the european group for blood and marrow transplantation', Clinical Infectious Diseases, vol. 57, no. 6, pp. 794-802. https://doi.org/10.1093/cid/cit391
Styczynski, Jan ; Gil, Lidia ; Tridello, Gloria ; Ljungman, Per ; Donnelly, J. Peter ; Van Der Velden, Walter ; Omar, Hamdy ; Martino, Rodrigo ; Halkes, Constantijn ; Faraci, Maura ; Theunissen, Koen ; Kalwak, Krzysztof ; Hubacek, Petr ; Sica, Simona ; Nozzoli, Chiara ; Fagioli, Franca ; Matthes, Susanne ; Diaz, Miguel A. ; Migliavacca, Maddalena ; Balduzzi, Adriana ; Tomaszewska, Agnieszka ; Camara, Rafael De La ; Van Biezen, Anja ; Hoek, Jennifer ; Iacobelli, Simona ; Einsele, Hermann ; Cesaro, Simone. / Response to rituximab-based therapy and risk factor analysis in epstein barr virus-related lymphoproliferative disorder after hematopoietic stem cell transplant in children and adults : A study from the infectious diseases working party of the european group for blood and marrow transplantation. In: Clinical Infectious Diseases. 2013 ; Vol. 57, No. 6. pp. 794-802.
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abstract = "Background. The objective of this analysis was to investigate prognostic factors that influence the outcome of Epstein-Barr virus (EBV)-related posttransplant lymphoproliferative disorder (PTLD) after a rituximab-based treatment in the allogeneic hematopoietic stem cell transplant (HSCT) setting.Methods. A total of 4466 allogeneic HSCTs performed between 1999 and 2011 in 19 European Group for Blood and Marrow Transplantation centers were retrospectively analyzed for PTLD, either biopsy-proven or probable disease.Results. One hundred forty-four cases of PTLD were identified, indicating an overall EBV-related PTLD frequency of 3.22{\%}, ranging from 1.16{\%} for matched-family donor, 2.86{\%} for mismatched family donor, 3.97{\%} in matched unrelated donors, and 11.24{\%} in mismatched unrelated donor recipients. In total, 69.4{\%} patients survived PTLD. Multivariable analysis showed that a poor response of PTLD to rituximab was associated with an age ≥30 years, involvement of extralymphoid tissue, acute GVHD, and a lack of reduction of immunosuppression upon PTLD diagnosis. In the prognostic model, the PTLD mortality increased with the increasing number of factors: 0-1, 2, or 3 factors being associated with mortality of 7{\%}, 37{\%}, and 72{\%}, respectively (P",
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T1 - Response to rituximab-based therapy and risk factor analysis in epstein barr virus-related lymphoproliferative disorder after hematopoietic stem cell transplant in children and adults

T2 - A study from the infectious diseases working party of the european group for blood and marrow transplantation

AU - Styczynski, Jan

AU - Gil, Lidia

AU - Tridello, Gloria

AU - Ljungman, Per

AU - Donnelly, J. Peter

AU - Van Der Velden, Walter

AU - Omar, Hamdy

AU - Martino, Rodrigo

AU - Halkes, Constantijn

AU - Faraci, Maura

AU - Theunissen, Koen

AU - Kalwak, Krzysztof

AU - Hubacek, Petr

AU - Sica, Simona

AU - Nozzoli, Chiara

AU - Fagioli, Franca

AU - Matthes, Susanne

AU - Diaz, Miguel A.

AU - Migliavacca, Maddalena

AU - Balduzzi, Adriana

AU - Tomaszewska, Agnieszka

AU - Camara, Rafael De La

AU - Van Biezen, Anja

AU - Hoek, Jennifer

AU - Iacobelli, Simona

AU - Einsele, Hermann

AU - Cesaro, Simone

PY - 2013/9/15

Y1 - 2013/9/15

N2 - Background. The objective of this analysis was to investigate prognostic factors that influence the outcome of Epstein-Barr virus (EBV)-related posttransplant lymphoproliferative disorder (PTLD) after a rituximab-based treatment in the allogeneic hematopoietic stem cell transplant (HSCT) setting.Methods. A total of 4466 allogeneic HSCTs performed between 1999 and 2011 in 19 European Group for Blood and Marrow Transplantation centers were retrospectively analyzed for PTLD, either biopsy-proven or probable disease.Results. One hundred forty-four cases of PTLD were identified, indicating an overall EBV-related PTLD frequency of 3.22%, ranging from 1.16% for matched-family donor, 2.86% for mismatched family donor, 3.97% in matched unrelated donors, and 11.24% in mismatched unrelated donor recipients. In total, 69.4% patients survived PTLD. Multivariable analysis showed that a poor response of PTLD to rituximab was associated with an age ≥30 years, involvement of extralymphoid tissue, acute GVHD, and a lack of reduction of immunosuppression upon PTLD diagnosis. In the prognostic model, the PTLD mortality increased with the increasing number of factors: 0-1, 2, or 3 factors being associated with mortality of 7%, 37%, and 72%, respectively (P

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KW - Epstein-Barr virus

KW - hematopoietic stem cell transplantation

KW - post-transplant lymphoproliferative disorder

KW - prognostic model

KW - risk factors

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