Survival outcomes of allogeneic hematopoietic cell transplants with EBV-positive or EBV-negative post-transplant lymphoproliferative disorder, A CIBMTR study

Seema Naik; Marcie Riches; Parameswaran Hari; Soyoung Kim; Min Chen; Carlos Bachier; Paul Shaughnessy; Joshua Hill; Per Ljungman; Minoo Battiwalla; Saurabh Chhabra; Andrew Daly; Jan Storek; Celalettin Ustun; Miguel Angel Diaz; Jan Cerny; Amer Beitinjaneh; Jean Yared; Valerie Brown; Kristin Page; Parastoo B. Dahi; Siddhartha Ganguly; Sachiko Seo; Nelson Chao; Cesar O. Freytes; Ayman Saad; Bipin N. Savani; Kwang Woo Ahn; Michael Boeckh; Helen E. Heslop; Hillard M. Lazarus; Jeffery J. Auletta; Rammurti T. Kamble

doi:10.1111/tid.13145

Survival outcomes of allogeneic hematopoietic cell transplants with EBV-positive or EBV-negative post-transplant lymphoproliferative disorder, A CIBMTR study

Seema Naik, Marcie Riches, Parameswaran Hari, Soyoung Kim, Min Chen, Carlos Bachier, Paul Shaughnessy, Joshua Hill, Per Ljungman, Minoo Battiwalla, Saurabh Chhabra, Andrew Daly, Jan Storek, Celalettin Ustun, Miguel Angel Diaz, Jan Cerny, Amer Beitinjaneh, Jean Yared, Valerie Brown, Kristin PageParastoo B. Dahi, Siddhartha Ganguly, Sachiko Seo, Nelson Chao, Cesar O. Freytes, Ayman Saad, Bipin N. Savani, Kwang Woo Ahn, Michael Boeckh, Helen E. Heslop, Hillard M. Lazarus, Jeffery J. Auletta, Rammurti T. Kamble

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

Background: Post-transplant lymphoproliferative disorders (PTLD) are associated with significant morbidity and mortality following allogeneic hematopoietic cell transplant (alloHCT). Although most PTLD is EBV-positive (EBV^pos), EBV-negative (EBV^neg) PTLD is reported, yet its incidence and clinical impact remain largely undefined. Furthermore, factors at the time of transplant impacting survival following PTLD are not well described. Methods: Between 2002 and 2014, 432 cases of PTLD following alloHCT were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). After exclusions, 267 cases (EBV^pos= 222, 83%; EBV^neg= 45, 17%) were analyzed. Results: Two hundred and eight patients (78%) received in vivo T-cell depletion (TCD) with either anti-thymocyte globulin (ATG) or alemtuzumab. Incidence of PTLD was highest using umbilical cord donors (UCB, 1.60%) and lowest using matched related donors (MRD, 0.40%). Clinical features and histology did not significantly differ among EBV^pos or EBV^negPTLD cases except that absolute lymphocyte count recovery was slower, and CMV reactivation was later in EBV^neg PTLD [EBV^pos 32 (5-95) days versus EBV^neg 47 (10-70) days, P =.016]. There was no impact on survival by EBV status in multivariable analysis [EBV^neg RR 1.42, 95% CI 0.94-2.15, P =.097]. Conclusions: There is no difference in survival outcomes for patients with EBV^pos or EBV^neg PTLD occurring following alloHCT and 1-year survival is poor. Features of conditioning and use of serotherapy remain important.

Original language	English (US)
Article number	e13145
Journal	Transplant Infectious Disease
Volume	21
Issue number	5
DOIs	https://doi.org/10.1111/tid.13145
State	Published - Oct 1 2019

Keywords

Epstein-Barr virus
allogeneic hematopoietic cell transplant
post-transplant lymphoproliferative disorder

ASJC Scopus subject areas

Transplantation
Infectious Diseases

Access to Document

10.1111/tid.13145

Cite this

Naik, S., Riches, M., Hari, P., Kim, S., Chen, M., Bachier, C., Shaughnessy, P., Hill, J., Ljungman, P., Battiwalla, M., Chhabra, S., Daly, A., Storek, J., Ustun, C., Diaz, M. A., Cerny, J., Beitinjaneh, A., Yared, J., Brown, V., ... Kamble, R. T. (2019). Survival outcomes of allogeneic hematopoietic cell transplants with EBV-positive or EBV-negative post-transplant lymphoproliferative disorder, A CIBMTR study. Transplant Infectious Disease, 21(5), Article e13145. https://doi.org/10.1111/tid.13145

Naik, S, Riches, M, Hari, P, Kim, S, Chen, M, Bachier, C, Shaughnessy, P, Hill, J, Ljungman, P, Battiwalla, M, Chhabra, S, Daly, A, Storek, J, Ustun, C, Diaz, MA, Cerny, J, Beitinjaneh, A, Yared, J, Brown, V, Page, K, Dahi, PB, Ganguly, S, Seo, S, Chao, N, Freytes, CO, Saad, A, Savani, BN, Woo Ahn, K, Boeckh, M, Heslop, HE, Lazarus, HM, Auletta, JJ & Kamble, RT 2019, 'Survival outcomes of allogeneic hematopoietic cell transplants with EBV-positive or EBV-negative post-transplant lymphoproliferative disorder, A CIBMTR study', Transplant Infectious Disease, vol. 21, no. 5, e13145. https://doi.org/10.1111/tid.13145

@article{6ca2ae6b3d3940b7a1dd8159b4eabaeb,

title = "Survival outcomes of allogeneic hematopoietic cell transplants with EBV-positive or EBV-negative post-transplant lymphoproliferative disorder, A CIBMTR study",

abstract = "Background: Post-transplant lymphoproliferative disorders (PTLD) are associated with significant morbidity and mortality following allogeneic hematopoietic cell transplant (alloHCT). Although most PTLD is EBV-positive (EBVpos), EBV-negative (EBVneg) PTLD is reported, yet its incidence and clinical impact remain largely undefined. Furthermore, factors at the time of transplant impacting survival following PTLD are not well described. Methods: Between 2002 and 2014, 432 cases of PTLD following alloHCT were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). After exclusions, 267 cases (EBVpos= 222, 83%; EBVneg= 45, 17%) were analyzed. Results: Two hundred and eight patients (78%) received in vivo T-cell depletion (TCD) with either anti-thymocyte globulin (ATG) or alemtuzumab. Incidence of PTLD was highest using umbilical cord donors (UCB, 1.60%) and lowest using matched related donors (MRD, 0.40%). Clinical features and histology did not significantly differ among EBVpos or EBVnegPTLD cases except that absolute lymphocyte count recovery was slower, and CMV reactivation was later in EBVneg PTLD [EBVpos 32 (5-95) days versus EBVneg 47 (10-70) days, P =.016]. There was no impact on survival by EBV status in multivariable analysis [EBVneg RR 1.42, 95% CI 0.94-2.15, P =.097]. Conclusions: There is no difference in survival outcomes for patients with EBVpos or EBVneg PTLD occurring following alloHCT and 1-year survival is poor. Features of conditioning and use of serotherapy remain important.",

keywords = "Epstein-Barr virus, allogeneic hematopoietic cell transplant, post-transplant lymphoproliferative disorder",

author = "Seema Naik and Marcie Riches and Parameswaran Hari and Soyoung Kim and Min Chen and Carlos Bachier and Paul Shaughnessy and Joshua Hill and Per Ljungman and Minoo Battiwalla and Saurabh Chhabra and Andrew Daly and Jan Storek and Celalettin Ustun and Diaz, {Miguel Angel} and Jan Cerny and Amer Beitinjaneh and Jean Yared and Valerie Brown and Kristin Page and Dahi, {Parastoo B.} and Siddhartha Ganguly and Sachiko Seo and Nelson Chao and Freytes, {Cesar O.} and Ayman Saad and Savani, {Bipin N.} and {Woo Ahn}, Kwang and Michael Boeckh and Heslop, {Helen E.} and Lazarus, {Hillard M.} and Auletta, {Jeffery J.} and Kamble, {Rammurti T.}",

note = "Publisher Copyright: {\textcopyright} 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",

year = "2019",

month = oct,

day = "1",

doi = "10.1111/tid.13145",

language = "English (US)",

volume = "21",

journal = "Transplant Infectious Disease",

issn = "1398-2273",

publisher = "Wiley",

number = "5",

}

TY - JOUR

T1 - Survival outcomes of allogeneic hematopoietic cell transplants with EBV-positive or EBV-negative post-transplant lymphoproliferative disorder, A CIBMTR study

AU - Naik, Seema

AU - Riches, Marcie

AU - Hari, Parameswaran

AU - Kim, Soyoung

AU - Chen, Min

AU - Bachier, Carlos

AU - Shaughnessy, Paul

AU - Hill, Joshua

AU - Ljungman, Per

AU - Battiwalla, Minoo

AU - Chhabra, Saurabh

AU - Daly, Andrew

AU - Storek, Jan

AU - Ustun, Celalettin

AU - Diaz, Miguel Angel

AU - Cerny, Jan

AU - Beitinjaneh, Amer

AU - Yared, Jean

AU - Brown, Valerie

AU - Page, Kristin

AU - Dahi, Parastoo B.

AU - Ganguly, Siddhartha

AU - Seo, Sachiko

AU - Chao, Nelson

AU - Freytes, Cesar O.

AU - Saad, Ayman

AU - Savani, Bipin N.

AU - Woo Ahn, Kwang

AU - Boeckh, Michael

AU - Heslop, Helen E.

AU - Lazarus, Hillard M.

AU - Auletta, Jeffery J.

AU - Kamble, Rammurti T.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: Post-transplant lymphoproliferative disorders (PTLD) are associated with significant morbidity and mortality following allogeneic hematopoietic cell transplant (alloHCT). Although most PTLD is EBV-positive (EBVpos), EBV-negative (EBVneg) PTLD is reported, yet its incidence and clinical impact remain largely undefined. Furthermore, factors at the time of transplant impacting survival following PTLD are not well described. Methods: Between 2002 and 2014, 432 cases of PTLD following alloHCT were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). After exclusions, 267 cases (EBVpos= 222, 83%; EBVneg= 45, 17%) were analyzed. Results: Two hundred and eight patients (78%) received in vivo T-cell depletion (TCD) with either anti-thymocyte globulin (ATG) or alemtuzumab. Incidence of PTLD was highest using umbilical cord donors (UCB, 1.60%) and lowest using matched related donors (MRD, 0.40%). Clinical features and histology did not significantly differ among EBVpos or EBVnegPTLD cases except that absolute lymphocyte count recovery was slower, and CMV reactivation was later in EBVneg PTLD [EBVpos 32 (5-95) days versus EBVneg 47 (10-70) days, P =.016]. There was no impact on survival by EBV status in multivariable analysis [EBVneg RR 1.42, 95% CI 0.94-2.15, P =.097]. Conclusions: There is no difference in survival outcomes for patients with EBVpos or EBVneg PTLD occurring following alloHCT and 1-year survival is poor. Features of conditioning and use of serotherapy remain important.

AB - Background: Post-transplant lymphoproliferative disorders (PTLD) are associated with significant morbidity and mortality following allogeneic hematopoietic cell transplant (alloHCT). Although most PTLD is EBV-positive (EBVpos), EBV-negative (EBVneg) PTLD is reported, yet its incidence and clinical impact remain largely undefined. Furthermore, factors at the time of transplant impacting survival following PTLD are not well described. Methods: Between 2002 and 2014, 432 cases of PTLD following alloHCT were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). After exclusions, 267 cases (EBVpos= 222, 83%; EBVneg= 45, 17%) were analyzed. Results: Two hundred and eight patients (78%) received in vivo T-cell depletion (TCD) with either anti-thymocyte globulin (ATG) or alemtuzumab. Incidence of PTLD was highest using umbilical cord donors (UCB, 1.60%) and lowest using matched related donors (MRD, 0.40%). Clinical features and histology did not significantly differ among EBVpos or EBVnegPTLD cases except that absolute lymphocyte count recovery was slower, and CMV reactivation was later in EBVneg PTLD [EBVpos 32 (5-95) days versus EBVneg 47 (10-70) days, P =.016]. There was no impact on survival by EBV status in multivariable analysis [EBVneg RR 1.42, 95% CI 0.94-2.15, P =.097]. Conclusions: There is no difference in survival outcomes for patients with EBVpos or EBVneg PTLD occurring following alloHCT and 1-year survival is poor. Features of conditioning and use of serotherapy remain important.

KW - Epstein-Barr virus

KW - allogeneic hematopoietic cell transplant

KW - post-transplant lymphoproliferative disorder

UR - http://www.scopus.com/inward/record.url?scp=85073491232&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073491232&partnerID=8YFLogxK

U2 - 10.1111/tid.13145

DO - 10.1111/tid.13145

M3 - Article

C2 - 31301099

AN - SCOPUS:85073491232

SN - 1398-2273

VL - 21

JO - Transplant Infectious Disease

JF - Transplant Infectious Disease

IS - 5

M1 - e13145

ER -

Survival outcomes of allogeneic hematopoietic cell transplants with EBV-positive or EBV-negative post-transplant lymphoproliferative disorder, A CIBMTR study

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this