title: Impact of Epstein Barr virus-related complications after high-risk allo-SCT in the era of pre-emptive rituximab.
abstract: 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).
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: García-Cadenas
authors.affiliation: Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Castillo
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Martino
authors.affiliation: Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Barba
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Esquirol
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Novelli
authors.affiliation: Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Orti
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Garrido
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Saavedra
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Moreno
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Granell
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Briones
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Brunet
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Navarro
authors.affiliation: Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Ruiz
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Rabella
authors.affiliation: Hospital Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Valcárcel
authors.affiliation: Hospital de la Santa Creu i Sant Pau, José Carreras Leukemia Research Institute, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sierra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D019337:Hematologic Neoplasms / Q000453:epidemiology / Q000628:therapy*; D004854:Herpesvirus 4, Human / Q000502:physiology*; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D000069283:Rituximab / Q000008:administration & dosage*; D033581:Stem Cell Transplantation; D014775:Virus Activation / Q000187:drug effects*
chemical_list: D007155:Immunologic Factors; D000069283:Rituximab