Prophylactic rituximab prevents EBV PTLD in haplo-cord transplant recipients at high risk

Koen Van Besien, Lizamarie Bachier-Rodriguez, Michael Satlin, Maxwell A. Brown, Usama Gergis, Danielle Guarneri, Jingmei Hsu, Adrienne A. Phillips, Sebastian A. Mayer, Amrita D. Singh, Rosemary Soave, Adriana Rossi, Catherine B. Small, Thomas J. Walsh, Hanna Rennert, Tsiporah B. Shore

Research output: Contribution to journalArticle

6 Scopus citations

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/m2 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% (p =.0017) and 0% (p =.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.

Original languageEnglish (US)
Pages (from-to)1693-1696
Number of pages4
JournalLeukemia and Lymphoma
Volume60
Issue number7
DOIs
StatePublished - Jun 7 2019

Keywords

  • EBV
  • Epstein–Barr virus
  • PTLD
  • rituximab
  • transplant toxicity

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Van Besien, K., Bachier-Rodriguez, L., Satlin, M., Brown, M. A., Gergis, U., Guarneri, D., Hsu, J., Phillips, A. A., Mayer, S. A., Singh, A. D., Soave, R., Rossi, A., Small, C. B., Walsh, T. J., Rennert, H., & Shore, T. B. (2019). Prophylactic rituximab prevents EBV PTLD in haplo-cord transplant recipients at high risk. Leukemia and Lymphoma, 60(7), 1693-1696. https://doi.org/10.1080/10428194.2018.1543877