Pre-emptive rituximab treatment for Epstein-Barr virus reactivation after allogeneic hematopoietic stem cell transplantation is a worthwhile strategy in high-risk recipients: a comparative study for immune recovery and clinical outcomes

被引：23

作者：

Stocker, Nicolas ^{[1
]}

Labopin, Myriam ^{[2
,3
]}

Boussen, Ines ^{[1
]}

Paccoud, Olivier ^{[4
]}

Bonnin, Agnes ^{[2
]}

Malard, Florent ^{[1
,2
]}

Amiel, Corinne ^{[5
]}

Gozlan, Joel ^{[6
]}

Battipaglia, Giorgia ^{[1
,2
]}

Dulery, Remy ^{[2
]}

Giannotti, Federica ^{[2
]}

Ruggeri, Annalisa ^{[2
]}

Gaugler, Beatrice ^{[1
,2
]}

Mohty, Mohamad ^{[1
,2
,3
]}

Brissot, Eolia ^{[1
,2
,3
]}

机构：

[1] Sorbonne Univ, CRSA, INSERM, F-75012 Paris, France

[2] Hop St Antoine, AP HP, Serv Hematol Clin & Therapie Cellulaire, F-75012 Paris, France

[3] European Soc Blood & Marrow Transplantat, Paris Study Off, Acute Leukemia Working Party, Paris, France

[4] Sorbonne Univ, Hop St Antoine, AP HP, Serv Malad Infect, F-75012 Paris, France

[5] Hop Tenon, AP HP, Serv Virol, F-75020 Paris, France

[6] Sorbonne Univ, Hop St Antoine, AP HP, Serv Virol, F-75012 Paris, France

来源：

BONE MARROW TRANSPLANTATION | 2020年 / 55卷 / 03期

关键词：

BONE-MARROW-TRANSPLANTATION; REGULATORY B-CELLS; POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER; RECONSTITUTION; BLOOD; DISEASES; MURINE; RECAPITULATION; CHEMOTHERAPY; THERAPY;

D O I：

10.1038/s41409-019-0699-6

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

This retrospective study evaluated the impact of a pre-emptive rituximab (RTX) strategy for Epstein-Barr virus (EBV) reactivation on immune recovery and outcomes of 219 high-risk recipients undergoing allogeneic stem cell transplantation (allo-SCT) for hematological malignancies or bone marrow failure. One-hundred and seven patients received pre-emptive RTX for EBV reactivation (RTX group) and 112 did not (control group). The median onset time of EBV reactivation was 49 days (range, 14-561), including five patients who developed post-transplant lymphoproliferative disorder (EBV-PTLD). RTX and control groups were pair-matched to assess the impact of RTX on all endpoints. In RTX patients, CD19 + B cells were significantly decreased until 1-year post-transplant, so were immunoglobulin levels. Twenty-one patients (17%) developed RTX-related neutropenia. There was, in the RTX group, a trend towards a lower cumulative incidence of chronic GvHD (P = 0.059). Overall survival, progression-free survival, non-relapse mortality, relapse incidence, and incidence of overall infections at 2 years following allo-SCT were comparable in the two groups. We conclude that pre-emptive RTX, despite inducing a delayed B-cell reconstitution and a high risk of RTX-related neutropenia, may be considered as a worthwhile treatment, given the absence of negative impact on post allo-SCT outcomes and a low incidence of EBV-PTLD.

引用

页码：586 / 594

页数：9

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