Incidence, risk factors, and clinical significance of Epstein–Barr virus reactivation in myelodysplastic syndrome after allogeneic haematopoietic stem cell transplantation

Epstein–Barr virus (EBV) reactivation is a life-threatening complication after allogeneic haematopoietic stem cell transplantation (allo-HSCT). In this study, we investigated the characteristics of EBV reactivation in 186 consecutive myelodysplastic (MDS) patients who underwent allo-HSCT in our cent...

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Bibliographic Details
Published in:Annals of hematology 2019-04, Vol.98 (4), p.987-996
Main Authors: Wang, Hong, Zhang, Tong-Tong, Qi, Jia-Qian, Chu, Tian-Tian, Miao, Miao, Qiu, Hui-Ying, Fu, Cheng-Cheng, Tang, Xiao-Wen, Ruan, Chang-Geng, Wu, De-Pei, Han, Yue
Format: Article
Language:English
Subjects:
Clinical significance
Epstein-Barr virus
Hematology
Medical prognosis
Medicine
Medicine & Public Health
Monoclonal antibodies
Myelodysplastic syndromes
Oncology
Original Article
Risk factors
Stem cell transplantation
Stem cells
Transplants & implants
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Summary:Epstein–Barr virus (EBV) reactivation is a life-threatening complication after allogeneic haematopoietic stem cell transplantation (allo-HSCT). In this study, we investigated the characteristics of EBV reactivation in 186 consecutive myelodysplastic (MDS) patients who underwent allo-HSCT in our centre. In 35 patients (18.8%) who experienced EBV reactivation after allo-HSCT, the median onset was 53 days (range 4–381 days). The cumulative incidence of EBV reactivation at the first, sixth, and twelfth month after allo-HSCT was 10.7%, 15.1%, and 17.9%, respectively. Twenty-five patients (71.4%) received pre-emptive rituximab therapy, and no patients developed post-transplant lymphoproliferative disorders. Stem cell source was proven to be a risk factor correlated with EBV reactivation. The cumulative incidence of relapse in the EBV-positive group was 11.4%, 25.2%, and 31.0% at the first, second, and third year after transplantation, respectively, being significantly higher than the corresponding 6.8%, 10.2%, and 10.2%, in the EBV-negative group ( P  = 0.014). Prognostic analysis showed that EBV reactivation was an independent risk factor for relapse-free survival (RFS). Patients in the EBV-positive group showed obviously shorter RFS than those in the EBV-negative group, with 3-year RFS of 62% and 85%, respectively ( P  = 0.017).
ISSN:0939-5555
1432-0584
DOI:10.1007/s00277-019-03603-3