EBV reactivation and post transplant lymphoproliferative disorders following allogeneic SCT.
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EBV reactivation and post transplant lymphoproliferative disorders following allogeneic SCT. / Ocheni, S; Kröger, Nicolaus; Zabelina, Tatjana; Sobottka, Ingo; Ayuketang Ayuk, Francis; Wolschke, Christine; Muth, A; Lellek, Heinrich; Petersen, L; Erttmann, Rudolf; Kabisch, Hartmut; Zander, Axel R.; Bacher, Ulrike.
in: BONE MARROW TRANSPL, Jahrgang 42, Nr. 3, 3, 2008, S. 181-186.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - EBV reactivation and post transplant lymphoproliferative disorders following allogeneic SCT.
AU - Ocheni, S
AU - Kröger, Nicolaus
AU - Zabelina, Tatjana
AU - Sobottka, Ingo
AU - Ayuketang Ayuk, Francis
AU - Wolschke, Christine
AU - Muth, A
AU - Lellek, Heinrich
AU - Petersen, L
AU - Erttmann, Rudolf
AU - Kabisch, Hartmut
AU - Zander, Axel R.
AU - Bacher, Ulrike
PY - 2008
Y1 - 2008
N2 - Fatal problems encountered in allogeneic stem cell transplantation include EBV reactivation and post transplant lymphoproliferative disorders (PTLDs) with high mortality rates. We performed a retrospective analysis in all consecutive adult and pediatric EBV reactivations and PTLD during a period of 8.5 years. There were 26 patients with EBV reactivation/PTLD out of a total of 854 transplantations giving an overall incidence of 3.0%. Specifically, the incidence of EBV-PTLD was 1.3%, whereas that of EBV reactivation was 1.8%. Median age was 46.0 and 11.0 years in the adult and pediatric patients, respectively. There were high rates (54%) of concomitant bacterial, viral, fungal and parasitic infections at the time of EBV manifestation. Variable treatment regimens were applied including in most cases an anti-CD20 regimen often in combination with virustatic compounds, polychemotherapy or donor lymphocytes. The mortality rates were 9 of 11 (82%) in patients with EBV-PTLD and 10 of 15 (67%) in patients with reactivation. Only 7 of 26 patients (27%) are alive after a median follow-up of 758 days (range 24-2751). The high mortality rates of EBV reactivation and of EBV-PTLD irrespective of multimodal treatment approaches emphasize standardization and optimization of post transplant surveillance and treatment strategies to improve control of these often fatal complications.
AB - Fatal problems encountered in allogeneic stem cell transplantation include EBV reactivation and post transplant lymphoproliferative disorders (PTLDs) with high mortality rates. We performed a retrospective analysis in all consecutive adult and pediatric EBV reactivations and PTLD during a period of 8.5 years. There were 26 patients with EBV reactivation/PTLD out of a total of 854 transplantations giving an overall incidence of 3.0%. Specifically, the incidence of EBV-PTLD was 1.3%, whereas that of EBV reactivation was 1.8%. Median age was 46.0 and 11.0 years in the adult and pediatric patients, respectively. There were high rates (54%) of concomitant bacterial, viral, fungal and parasitic infections at the time of EBV manifestation. Variable treatment regimens were applied including in most cases an anti-CD20 regimen often in combination with virustatic compounds, polychemotherapy or donor lymphocytes. The mortality rates were 9 of 11 (82%) in patients with EBV-PTLD and 10 of 15 (67%) in patients with reactivation. Only 7 of 26 patients (27%) are alive after a median follow-up of 758 days (range 24-2751). The high mortality rates of EBV reactivation and of EBV-PTLD irrespective of multimodal treatment approaches emphasize standardization and optimization of post transplant surveillance and treatment strategies to improve control of these often fatal complications.
M3 - SCORING: Zeitschriftenaufsatz
VL - 42
SP - 181
EP - 186
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 3
M1 - 3
ER -