Epstein–Barr virus and cytomegalovirus reactivation after allogeneic hematopoietic cell transplantation in patients with non–Hodgkin lymphoma: the prevalence and impacts on outcomes

Autor: Tiemei Song, Yang Xu, Yuqing Tu, Haiwen Huang, Lingchuan Guo, Caixia Li, Jia Chen, Mimi Xu, Zhengming Jin, Yiyang Ding, Depei Wu, Yuhua Ru, Jinjin Zhu, Xiang Zhang
Rok vydání: 2021
Předmět:
Adult
Male
Oncology
Epstein-Barr Virus Infections
Herpesvirus 4
Human
medicine.medical_specialty
Transplantation Conditioning
Cytomegalovirus
Graft vs Host Disease
medicine.disease_cause
Lower risk
Immunotherapy
Adoptive
Epstein–Barr virus
International Prognostic Index
Risk Factors
hemic and lymphatic diseases
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Prevalence
Humans
Medicine
Proportional Hazards Models
Retrospective Studies
Non-Hodgkin lymphoma
Hematology
business.industry
Lymphoma
Non-Hodgkin
Lymphoblastic lymphoma
Hematopoietic Stem Cell Transplantation
General Medicine
Allogeneic hematopoietic cell transplantation
Allografts
Prognosis
medicine.disease
Combined Modality Therapy
Lymphoma
Transplantation
Treatment Outcome
Cytomegalovirus Infections
Female
Virus Activation
Original Article
Rituximab
business
Whole-Body Irradiation
medicine.drug
Zdroj: Annals of Hematology
ISSN: 1432-0584
0939-5555
Popis: Epstein–Barr virus (EBV) and cytomegalovirus (CMV) reactivations are common complications after allogeneic hematopoietic cell transplantation (allo-HCT), but data focusing on non–Hodgkin lymphoma (NHL) are limited. We retrospectively analyzed the prevalence of EBV and CMV reactivation post-allo-HCT and the impacts on transplant outcomes in 160 NHL patients. The 1-year incidences of EBV and CMV reactivation were 22.58% and 25.55%, respectively. Independent impactors for EBV reactivation were more than 6 lines of chemotherapy (P = 0.030), use of rituximab (P = 0.004), and neutrophil recovery within 30 days post-HCT (P = 0.022). For T-cell lymphoblastic lymphoma patients, the International Prognostic Index (IPI) (P = 0.015) and chronic GVHD (P = 0.001) increased the risk of CMV reactivation. CMV reactivation was independently related to a lower risk of relapse (P = 0.027) but higher transplant-related mortality (TRM) (P = 0.038). Although viral reactivation had no significant impact on overall survival (OS) in the whole cohort, it led to an inferior 2-year OS (67.6% versus 92.5%, P = 0.005) and TRM (20.1% versus 4.7%, P = 0.020) in recipients surviving for more than 180 days. We concluded that EBV and CMV reactivation post-allotransplant still deserved concern particularly in NHL patients with high-risk factors, since it is generally related to a deteriorated prognosis. Large-scale studies are warranted to validate our findings.
Databáze: OpenAIRE
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