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

Research output: Contribution to journalArticle

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

Keywords

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

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

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    Styczynski, J., Gil, L., Tridello, G., Ljungman, P., Donnelly, J. P., 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, M. A., Migliavacca, M., ... 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, 57(6), 794-802. https://doi.org/10.1093/cid/cit391