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Bone Marrow Transplant. 2019 Jul 30. doi: 10.1038/s41409-019-0627-9. [Epub ahead of print]

Prognostic impact of EBV serostatus in patients with lymphomas or chronic malignancies undergoing allogeneic HCT.

Author information

1
Department of Pediatric Hematology and Oncology, Jurasz University Hospital, Collegium Medicum UMK Torun, Bydgoszcz, Poland. jstyczynski@cm.umk.pl.
2
Pediatric Hematology Oncology, Ospedale Donna Bambino, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
3
Department of Hematology, Medical University, Poznan, Poland.
4
Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden.
5
Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
6
Division of Infectious Diseases, Department of Health Sciences, University of Genova, Ospedale Policlinco San Martino, Genova, Italy.
7
University College London, London, United Kingdom.
8
Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris (AP-HP) and Paris-Est-Créteil University, Creteil, France.
9
Hospital de la Princesa, Madrid, Spain.
10
Hadassah University Hospital, Jerusalem, Israel.
11
EBMT Data Office, Leiden, Netherlands.
12
Hôpital St. Louis, Paris, France.
13
CHU Nantes, Nantes, France.
14
Institut Paoli Calmettes, Marseille, France.
15
CHU de Lille, LIRIC, INSERM U995, Université de Lille2, Lille, 59000, France.
16
CHU Bordeaux, Hopital Haut-leveque, Pessac, France.
17
Erasmus MC Cancer Institute, Rotterdam, Netherlands.
18
University Hospital Gasthuisberg, Leuven, Belgium.
19
University Medical Centre, Utrecht, Netherlands.
20
Hopital la Pitié-Salpêtrière, Paris, France.
21
Leiden University Hospital, Leiden, Netherlands.
22
Radboud University Medical Centre, Nijmegen, Netherlands.
23
University Hospital, Basel, Switzerland.
24
Centre Hospitalier Lyon Sud, Lyon, France.
25
CHU Lapeyronie, Montpellier, France.
26
Hôpital Jean Minjoz, Besancon, France.
27
Nottingham University, Nottingham, United Kingdom.
28
Department of Hematology, Medical University, Warsaw, Poland.
29
Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany.
30
St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
31
University Hospital Eppendorf, Hamburg, Germany.

Abstract

The influence of the donor (D) and recipient (R) pre-transplant Epstein-Barr Virus (EBV) serostatus on transplant outcomes (overall survival, relapse-free survival, relapse incidence, non-relapse mortality, acute and chronic GVHD) in 12,931 patients with lymphomas or chronic malignancies undergoing allogeneic hematopoietic cell transplant (allo-HCT) between 1997-2016 was analyzed. In multivariate analysis, the risk of development of chronic GVHD was increased for EBV R+/D+ (HR = 1.26; p = 0.003), R+/D- (HR = 1.21; p = 0.044), and R-/D + (HR = 1.21; p = 0.048) in comparison to R-/D- transplants. No significance was shown for other transplant outcomes; however, in univariate analysis, EBV-seropositive patients receiving grafts from EBV-seropositive donors (EBV R+/D+transplants) had inferior transplant outcomes in comparison to EBV-seronegative recipients of grafts from EBV-seronegative donors (EBV R-/D-): inferior overall survival (59.6% vs 65.9%), inferior relapse-free survival (51.1% vs 57.5%), increased incidence of chronic GVHD (49.5% vs 41.8%), and increased incidence of de novo chronic GVHD (30.5% vs 24.0%). In conclusion, an EBV-negative recipient with lymphoma or chronic malignancy can benefit from selection of an EBV-negative donor in context of chronic GVHD, while there are no preferences in donor EBV serostatus for EBV-seropositive recipient.

PMID:
31363166
DOI:
10.1038/s41409-019-0627-9

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