High incidence but low mortality of EBV-reactivation and PTLD after alloHCT using ATG and PTCy for GVHD prophylaxis. Issue 13 (9th November 2020)

• Record Type: Journal Article
• Authors: Salas, Maria Queralt; Prem, Shruti; Remberger, Mats; Lam, Wilson; Kim, Dennis Dong Hwan; Michelis, Fotios Vasilios; Al-Shaibani, Zeyad; Gerbitz, Armin; Lipton, Jeffrey Howard; Viswabandya, Auro; Kumar, Rajat; Kumar, Deepali; Mattsson, Jonas; Law, Arjun Datt
• Is Part Of: Leukemia & lymphoma. Volume 61:Issue 13(2020)
• Page Start: 3198
• Page End: 3208
• Publication Date: 2020-11-09
• Subjects: Epstein-Barr Virus -- PTLD -- alloHCT -- reduced intensity conditioning -- ATG -- PTCy; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2020.1797010
• Languages: English
• ISSNs: 1042-8194

Abstract

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 2 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.