TY - JOUR
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
AB - 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
KW - Epstein-Barr virus
KW - hematopoietic stem cell transplantation
KW - post-transplant lymphoproliferative disorder
KW - prognostic model
KW - risk factors
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U2 - 10.1093/cid/cit391
DO - 10.1093/cid/cit391
M3 - Article
C2 - 23771985
AN - SCOPUS:84883243154
SN - 1058-4838
VL - 57
SP - 794
EP - 802
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 6
ER -