Title | Prophylactic rituximab prevents EBV PTLD in haplo-cord transplant recipients at high risk. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Van Besien K, Bachier-Rodriguez L, Satlin M, Brown MA, Gergis U, Guarneri D, Hsu JM, Phillips AA, Mayer SA, Singh AD, Soave R, Rossi A, Small CB, Walsh TJ, Rennert H, Shore TB |
Journal | Leuk Lymphoma |
Volume | 60 |
Issue | 7 |
Pagination | 1693-1696 |
Date Published | 2019 07 |
ISSN | 1029-2403 |
Keywords | Adult, Aged, Antineoplastic Agents, Immunological, Cord Blood Stem Cell Transplantation, Epstein-Barr Virus Infections, Female, Follow-Up Studies, Hematologic Neoplasms, Herpesvirus 4, Human, Histocompatibility Testing, Humans, Incidence, Lymphoproliferative Disorders, Male, Middle Aged, New York, Prognosis, Risk Factors, Rituximab, Survival Rate, Transplant Recipients, Transplantation Conditioning, Transplantation, Haploidentical, Virus Activation, Young Adult |
Abstract | Epstein-Barr virus (EBV) reactivation and post-transplant lymphoproliferative disorders (PTLD) are common and potentially fatal complications after allogeneic transplantation with mismatched donors and T-cell depletion. Haplo-cord transplantation combines a mismatched UCB graft with third-party cells. Conditioning involves thymoglobulin. EBV reactivation and PTLD were common in initial patients. As of March 2017, we administered a prophylactic dose of rituximab 375 mg/m pre-transplant. Among 147 patients who did not receive rituximab, the cumulative incidence of post-transplant EBV reactivation and of EBV PTLD was 13% and 8%, respectively. Among 51 who received pre-transplant rituximab, the incidences were 2% ( = .0017) and 0% ( = .04), respectively. There was no difference in time to hematopoietic recovery, in the incidence of CMV reactivation, of invasive blood stream infections or of proven or probable invasive fungal infections. Pre-transplant administration of rituximab is an effective and nontoxic intervention that drastically reduces EBV reactivation and PTLD in high-risk patients. |
DOI | 10.1080/10428194.2018.1543877 |
Alternate Journal | Leuk Lymphoma |
PubMed ID | 30741059 |
Related Faculty:
Hanna Rennert, Ph.D.