Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab

I. García-Cadenas; N. Castillo; R. Martino; P. Barba; A. Esquirol; S. Novelli; G. Orti; A. Garrido; S. Saavedra; C. Moreno; M. Granell; J. Briones; S. Brunet; F. Navarro; I. Ruiz; N. Rabella; D. Valcárcel; J. Sierra

doi:10.1038/bmt.2014.298

Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab

I. García-Cadenas, N. Castillo, R. Martino, P. Barba, A. Esquirol, S. Novelli, G. Orti, A. Garrido, S. Saavedra, C. Moreno, M. Granell, J. Briones, S. Brunet, F. Navarro, I. Ruiz, N. Rabella, D. Valcárcel, J. Sierra

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Abstract

© 2015 Macmillan Publishers Limited. We monitored 133 high-risk allo-SCT recipients for 6 months after transplant for EBV reactivation by quantitative real-time PCR. Rituximab was given as pre-emptive therapy for viremia >1000 copies/mL. The 1-year cumulative incidence of EBV reactivation was 29.4% (95% confidence interval (CI): 18-40) in patients monitored due to initial high-risk characteristics (n=93) and 31.8% (95% CI: 19.7-44) in those followed because of the development of refractory GVHD (n=40). Overall response rate to Rituximab was 83%. Nine patients (9.6%) developed post-transplant lymphoproliferative disorder (PTLD) at a median of +62 days after SCT. Eight of them showed a concomitant CMV reactivation. Second SCT was the only risk factor associated with EBV infection and PTLD in multivariate analysis (hazard ratio (HR) 2.6 (95% CI: 1.1-6.4; P=0.04) and HR 6.4 (95%CI: 1.3-32; P=0.02)). The development of EBV reactivation was not associated with non-relapse mortality or OS (P=0.97 and P=0.84, respectively).

Original language	English
Pages (from-to)	579-584
Journal	Bone Marrow Transplantation
Volume	50
Issue number	4
DOIs	https://doi.org/10.1038/bmt.2014.298
Publication status	Published - 4 Apr 2015

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García-Cadenas, I., Castillo, N., Martino, R., Barba, P., Esquirol, A., Novelli, S., Orti, G., Garrido, A., Saavedra, S., Moreno, C., Granell, M., Briones, J., Brunet, S., Navarro, F., Ruiz, I., Rabella, N., Valcárcel, D., & Sierra, J. (2015). Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab. Bone Marrow Transplantation, 50(4), 579-584. https://doi.org/10.1038/bmt.2014.298

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title = "Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab",

abstract = "{\textcopyright} 2015 Macmillan Publishers Limited. We monitored 133 high-risk allo-SCT recipients for 6 months after transplant for EBV reactivation by quantitative real-time PCR. Rituximab was given as pre-emptive therapy for viremia >1000 copies/mL. The 1-year cumulative incidence of EBV reactivation was 29.4% (95% confidence interval (CI): 18-40) in patients monitored due to initial high-risk characteristics (n=93) and 31.8% (95% CI: 19.7-44) in those followed because of the development of refractory GVHD (n=40). Overall response rate to Rituximab was 83%. Nine patients (9.6%) developed post-transplant lymphoproliferative disorder (PTLD) at a median of +62 days after SCT. Eight of them showed a concomitant CMV reactivation. Second SCT was the only risk factor associated with EBV infection and PTLD in multivariate analysis (hazard ratio (HR) 2.6 (95% CI: 1.1-6.4; P=0.04) and HR 6.4 (95%CI: 1.3-32; P=0.02)). The development of EBV reactivation was not associated with non-relapse mortality or OS (P=0.97 and P=0.84, respectively).",

author = "I. Garc{\'i}a-Cadenas and N. Castillo and R. Martino and P. Barba and A. Esquirol and S. Novelli and G. Orti and A. Garrido and S. Saavedra and C. Moreno and M. Granell and J. Briones and S. Brunet and F. Navarro and I. Ruiz and N. Rabella and D. Valc{\'a}rcel and J. Sierra",

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doi = "10.1038/bmt.2014.298",

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García-Cadenas, I, Castillo, N, Martino, R, Barba, P, Esquirol, A, Novelli, S, Orti, G, Garrido, A, Saavedra, S, Moreno, C, Granell, M, Briones, J, Brunet, S, Navarro, F, Ruiz, I, Rabella, N, Valcárcel, D & Sierra, J 2015, 'Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab', Bone Marrow Transplantation, vol. 50, no. 4, pp. 579-584. https://doi.org/10.1038/bmt.2014.298

TY - JOUR

T1 - Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab

AU - García-Cadenas, I.

AU - Castillo, N.

AU - Martino, R.

AU - Barba, P.

AU - Esquirol, A.

AU - Novelli, S.

AU - Orti, G.

AU - Garrido, A.

AU - Saavedra, S.

AU - Moreno, C.

AU - Granell, M.

AU - Briones, J.

AU - Brunet, S.

AU - Navarro, F.

AU - Ruiz, I.

AU - Rabella, N.

AU - Valcárcel, D.

AU - Sierra, J.

PY - 2015/4/4

Y1 - 2015/4/4

N2 - © 2015 Macmillan Publishers Limited. We monitored 133 high-risk allo-SCT recipients for 6 months after transplant for EBV reactivation by quantitative real-time PCR. Rituximab was given as pre-emptive therapy for viremia >1000 copies/mL. The 1-year cumulative incidence of EBV reactivation was 29.4% (95% confidence interval (CI): 18-40) in patients monitored due to initial high-risk characteristics (n=93) and 31.8% (95% CI: 19.7-44) in those followed because of the development of refractory GVHD (n=40). Overall response rate to Rituximab was 83%. Nine patients (9.6%) developed post-transplant lymphoproliferative disorder (PTLD) at a median of +62 days after SCT. Eight of them showed a concomitant CMV reactivation. Second SCT was the only risk factor associated with EBV infection and PTLD in multivariate analysis (hazard ratio (HR) 2.6 (95% CI: 1.1-6.4; P=0.04) and HR 6.4 (95%CI: 1.3-32; P=0.02)). The development of EBV reactivation was not associated with non-relapse mortality or OS (P=0.97 and P=0.84, respectively).

AB - © 2015 Macmillan Publishers Limited. We monitored 133 high-risk allo-SCT recipients for 6 months after transplant for EBV reactivation by quantitative real-time PCR. Rituximab was given as pre-emptive therapy for viremia >1000 copies/mL. The 1-year cumulative incidence of EBV reactivation was 29.4% (95% confidence interval (CI): 18-40) in patients monitored due to initial high-risk characteristics (n=93) and 31.8% (95% CI: 19.7-44) in those followed because of the development of refractory GVHD (n=40). Overall response rate to Rituximab was 83%. Nine patients (9.6%) developed post-transplant lymphoproliferative disorder (PTLD) at a median of +62 days after SCT. Eight of them showed a concomitant CMV reactivation. Second SCT was the only risk factor associated with EBV infection and PTLD in multivariate analysis (hazard ratio (HR) 2.6 (95% CI: 1.1-6.4; P=0.04) and HR 6.4 (95%CI: 1.3-32; P=0.02)). The development of EBV reactivation was not associated with non-relapse mortality or OS (P=0.97 and P=0.84, respectively).

U2 - 10.1038/bmt.2014.298

DO - 10.1038/bmt.2014.298

M3 - Article

SN - 0268-3369

VL - 50

SP - 579

EP - 584

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

IS - 4

ER -

Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab

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