Impact of Donor Epstein-Barr Virus Serostatus on the Incidence of Graft-Versus-Host Disease in Patients With Acute Leukemia After Hematopoietic Stem-Cell Transplantation: A Study From the Acute Leukemia and Infectious Diseases Working Parties of the European Society for Blood and Marrow Transplantation

被引：39

作者：

Styczynski, Jan ^{[1
]}

Tridello, Gloria ^{[3
]}

Gil, Lidia ^{[2
]}

Ljungman, Per ^{[5
]}

Hoek, Jennifer ^{[6
]}

Iacobelli, Simona ^{[4
]}

Ward, Katherine N. ^{[10
]}

Cordonnier, Catherine ^{[11
,12
]}

Einsele, Hermann ^{[21
]}

Socie, Gerard ^{[13
]}

Milpied, Noel ^{[15
]}

Veelken, Hendrik ^{[7
]}

Chevallier, Patrice ^{[16
]}

Yakoub-Agha, Ibrahim ^{[17
]}

Maertens, Johan ^{[24
]}

Blaise, Didier ^{[18
]}

Cornelissen, Jan ^{[8
]}

Michallet, Mauricette ^{[19
]}

Daguindau, Etienne ^{[20
]}

Petersen, Eefke ^{[9
]}

Passweg, Jakob ^{[25
]}

Greinix, Hildegard ^{[26
]}

Duarte, Rafael F. ^{[27
]}

Kroeger, Nicolaus ^{[22
]}

Dreger, Peter ^{[23
]}

Mohty, Mohamad ^{[14
]}

Nagler, Arnon ^{[28
]}

Cesaro, Simone ^{[3
]}

机构：

[1] Nicolaus Copernicus Univ Torun, Coll Med, Bydgoszcz, Poland

[2] Med Univ, Poznan, Poland

[3] Azienda Osped Univ Integrata, Verona, Italy

[4] Univ Roma Tor Vergata, Rome, Italy

[5] Karolinska Univ Hosp, Stockholm, Sweden

[6] European Bone Marrow Transplantat Grp Data Off, Leiden, Netherlands

[7] Leiden Univ, Med Ctr, Leiden, Netherlands

[8] Erasmus MC, Daniel den Hoed Canc Ctr, Rotterdam, Netherlands

[9] Univ Med Ctr, Utrecht, Netherlands

[10] UCL, London, England

[11] Hop Henri Mondor, AP HP, F-94010 Creteil, France

[12] Paris Est Creteil Univ, Creteil, France

[13] Hop St Louis, Paris, France

[14] St Antoine Hosp, UMR 938, INSERM, Paris, France

[15] Ctr Hosp Univ Bordeaux, Pessac, France

[16] CHU Nantes, F-44035 Nantes 01, France

[17] CHRU Lille, F-59037 Lille, France

[18] Ctr Rech Cancerol, Marseille, France

[19] Ctr Hosp Lyon Sud, F-69310 Pierre Benite, France

[20] Hop Jean Minjoz, F-25030 Besancon, France

[21] Univ Hosp, Wurzburg, Germany

[22] Univ Hosp Eppendorf, Hamburg, Germany

[23] Heidelberg Univ, Heidelberg, Germany

[24] Univ Hosp Gasthuisberg, Leuven, Belgium

[25] Univ Basel Hosp, CH-4031 Basel, Switzerland

[26] Med Univ Graz, Graz, Austria

[27] Hosp Univ Puerta de Hierro Majadahonda, Madrid, Spain

[28] Chaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2016年 / 34卷 / 19期

关键词：

MONOCLONAL-ANTIBODY TREATMENT; TREATMENT-RELATED MORTALITY; BONE-MARROW; LYMPHOPROLIFERATIVE DISORDER; HEMATOLOGICAL MALIGNANCIES; UNRELATED DONORS; RISK-FACTORS; CHRONIC GVHD; RITUXIMAB; RECIPIENTS;

D O I：

10.1200/JCO.2015.64.2405

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose We investigated the effect of Epstein-Barr virus (EBV) serostatus on the overall outcome of allogeneic hematopoietic stem-cell transplantation (allo-HSCT). Patients and Methods The study included 11,364 patients who underwent allogeneic peripheral-blood or bone marrow transplantation for acute leukemia between 1997 and 2012. We analyzed the impact of donor and recipient EBV serologic status on overall survival, relapse-free survival, relapse incidence, non-relapse mortality, and incidence of graft-versus-host disease (GVHD) after allo-HSCT. Results Patients receiving grafts from EBV-seropositive donors had the same overall survival as patients who received grafts from EBV-seronegative donors (hazard ratio [HR], 1.05; 95% CI, 0.97 to 1.12; P = .23). Seropositive donors also had no influence on relapse-free survival (HR, 1.04; 95% CI, 0.97 to 1.11; P = 0.31), relapse incidence (HR, 1.03; 95% CI, 0.94 to 1.12; P = .58), and nonrelapse mortality (HR, 1.05; 95% CI, 0.94 to 1.17; P = .37). However, in univariate analysis, recipients receiving grafts from seropositive donors had a higher risk of chronic GVHD than those with seronegative donors (40.8% v31.0%, respectively; P < .001; HR, 1.42; 95% CI, 1.30 to 1.56). When adjusting for confounders, higher risk was identified for both acute and chronic GVHD. In seronegative patients with seropositive donors, the HR for chronic GVHD was 1.30 (95% CI, 1.06 to 1.59; P = .039). In seropositive patients with seropositive donors, the HR was 1.24 (95% CI, 1.07 to 1.45; P = .016) for acute GVHD and 1.43 (95% CI, 1.23 to 1.67; P < .001) for chronic GVHD. Seropositive patients with seronegative donors did not have an increased risk of GVHD. Conclusion Our data suggest that donor EBV status significantly influences development of acute and chronic GVHD after allo-HSCT. (C) 2016 by American Society of Clinical Oncology

引用

页码：2212 / +

页数：11

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