Epstein-Barr virus infections after allogeneic stem cell transplantation: a comparison between non-malignant and malignant hematological disorders

TY - JOUR

T1 - Epstein-Barr virus infections after allogeneic stem cell transplantation

T2 - a comparison between non-malignant and malignant hematological disorders

AU - Islam, Md Serajul

AU - Anoop, Parameswaran

AU - Gordon-Smith, Edward C.

AU - Rice, Phil

AU - Datta-Nemdharry, Preeti

AU - Marsh, Judith

PY - 2010/10

Y1 - 2010/10

N2 - Hematological cancers and non-malignant hematological disorders are biologically diverse conditions and are treated differently. We compared the pattern of EBV infections following allogeneic stem cell transplantation between the above two groups of hematological disorders. Eighty-three transplants were evaluated over a consecutive 7-year period at a single center. No difference was found in the incidence of post-transplant EBV infections between the two groups, though a higher median peak viral load was noted in the non-malignant group (P=0.04). Pre-transplant immunosuppressive therapy with antithymocyte globulin (ATG) significantly increased the risk of post-transplant EBV infections (P=0.04) in the non-malignant group patients. No significance was found for prior cytotoxic chemotherapy among the malignant group of patients. Alemtuzumab based conditioning was not associated with an increased risk for EBV infections in either of the groups. Treatment with two or more courses of ATG was found to be significantly associated with post-transplant EBV-related PTLD (P=0.01). Post-transplant EBV infections did not influence overall survival (non-malignant, P=0.66; malignant, P=0.41) in either of the subgroups. There were no deaths directly attributable to EBV infections.

AB - Hematological cancers and non-malignant hematological disorders are biologically diverse conditions and are treated differently. We compared the pattern of EBV infections following allogeneic stem cell transplantation between the above two groups of hematological disorders. Eighty-three transplants were evaluated over a consecutive 7-year period at a single center. No difference was found in the incidence of post-transplant EBV infections between the two groups, though a higher median peak viral load was noted in the non-malignant group (P=0.04). Pre-transplant immunosuppressive therapy with antithymocyte globulin (ATG) significantly increased the risk of post-transplant EBV infections (P=0.04) in the non-malignant group patients. No significance was found for prior cytotoxic chemotherapy among the malignant group of patients. Alemtuzumab based conditioning was not associated with an increased risk for EBV infections in either of the groups. Treatment with two or more courses of ATG was found to be significantly associated with post-transplant EBV-related PTLD (P=0.01). Post-transplant EBV infections did not influence overall survival (non-malignant, P=0.66; malignant, P=0.41) in either of the subgroups. There were no deaths directly attributable to EBV infections.

KW - EBV

KW - risk

KW - transplantation

KW - non-malignant

KW - malignant

KW - ACQUIRED APLASTIC-ANEMIA

KW - VERSUS-HOST-DISEASE

KW - LYMPHOPROLIFERATIVE DISEASE

KW - EBV REACTIVATION

KW - T-LYMPHOCYTES

KW - HIGH-RISK

KW - SCT

KW - RECONSTITUTION

KW - LOAD

U2 - 10.1179/102453310X12647083621047

DO - 10.1179/102453310X12647083621047

M3 - Article

SN - 1024-5332

VL - 15

SP - 344

EP - 350

JO - HEMATOLOGY

JF - HEMATOLOGY

IS - 5

ER -