Prophylactic rituximab prevents EBV PTLD in haplo-cord transplant recipients at high risk. Academic Article uri icon

Overview

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.

publication date

  • February 10, 2019

Research

keywords

  • Cord Blood Stem Cell Transplantation
  • Epstein-Barr Virus Infections
  • Hematologic Neoplasms
  • Lymphoproliferative Disorders
  • Rituximab
  • Transplant Recipients
  • Virus Activation

Identity

Scopus Document Identifier

  • 85061438555

Digital Object Identifier (DOI)

  • 10.1080/10428194.2018.1543877

PubMed ID

  • 30741059

Additional Document Info

volume

  • 60

issue

  • 7