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 language | English (US) |
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Pages (from-to) | 1693-1696 |
Number of pages | 4 |
Journal | Leukemia and Lymphoma |
Volume | 60 |
Issue number | 7 |
DOIs | |
State | Published - Jun 7 2019 |
Externally published | Yes |
Keywords
- EBV
- Epstein–Barr virus
- PTLD
- rituximab
- transplant toxicity
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research