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Post-Transplant Events

EBV reactivation and post transplant lymphoproliferative disorders following allogeneic SCT

Bone Marrow Transplantation volume 42, pages 181–186 (2008)Cite this article

Abstract

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.

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Acknowledgements

The authors appreciate the dedicated care of patients by all members of the Transplantation Team. Dr S Ocheni is grateful to Professor A R Zander and Professor N Kroeger for a Clinical Fellowship at the Stem Cell Transplantation Department of the University of Hamburg, Germany.

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Authors and Affiliations

  1. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    S Ocheni, N Kroeger, T Zabelina, F Ayuk, C Wolschke, A Muth, H Lellek, L Petersen, A R Zander & U Bacher

  2. Department of Haematology and Immunology, University of Nigeria–Enugu Campus, Enugu, Nigeria

    S Ocheni

  3. Department of Medical Microbiology and Virology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    I Sobottka

  4. Department of Pediatric Hematolog and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    R Erttmann & H Kabisch

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  1. S Ocheni
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Correspondence to U Bacher.

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Ocheni, S., Kroeger, N., Zabelina, T. et al. EBV reactivation and post transplant lymphoproliferative disorders following allogeneic SCT. Bone Marrow Transplant 42, 181–186 (2008). https://doi.org/10.1038/bmt.2008.150

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  • DOI: https://doi.org/10.1038/bmt.2008.150

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