Prognostic impact of EBV serostatus in patients with lymphomas or chronic malignancies undergoing allogeneic HCT

Abstract

The influence of the donor (D) and recipient (R) pre-transplant Epstein-Barr Virus (EBV) serostatus on transplant outcomes (overall survival, relapse-free survival, relapse incidence, non-relapse mortality, acute and chronic GVHD) in 12,931 patients with lymphomas or chronic malignancies undergoing allogeneic hematopoietic cell transplant (allo-HCT) between 1997–2016 was analyzed. In multivariate analysis, the risk of development of chronic GVHD was increased for EBV R+/D+ (HR = 1.26; p = 0.003), R+/D− (HR = 1.21; p = 0.044), and R−/D + (HR = 1.21; p = 0.048) in comparison to R−/D− transplants. No significance was shown for other transplant outcomes; however, in univariate analysis, EBV-seropositive patients receiving grafts from EBV-seropositive donors (EBV R+/D+transplants) had inferior transplant outcomes in comparison to EBV-seronegative recipients of grafts from EBV-seronegative donors (EBV R−/D−): inferior overall survival (59.6% vs 65.9%), inferior relapse-free survival (51.1% vs 57.5%), increased incidence of chronic GVHD (49.5% vs 41.8%), and increased incidence of de novo chronic GVHD (30.5% vs 24.0%). In conclusion, an EBV-negative recipient with lymphoma or chronic malignancy can benefit from selection of an EBV-negative donor in context of chronic GVHD, while there are no preferences in donor EBV serostatus for EBV-seropositive recipient.

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Acknowledgements

The authors thank all EBMT transplant centers for reporting data to the EBMT Registry.

Author information

Study design: JS, LG and SC; Data analysis and interpretation: JS, GT, LG, NKn, MMik and PL; Manuscript writing: JS, GT, LG and KNW; Provision of important clinical data: JS, LG, PL, CC, RdlC, DA, GS, PC, DB, IYA, EF, JC, JM, EP, SNQ, HV, NS, JP, MMic, NF, ED, NR, GB, PB, SM, NKr and SC; Microbiology check-up: KNW; Data check-up: NKn and GT; Statistical analysis: GT; Administrative support: JS, NKn and SC; Revision of manuscript: All authors; Final approval: All authors.

Correspondence to Jan Styczynski.

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The authors declare that they have no conflict of interest.

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Results of this study were presented at 59th Annual Meeting of American Society of Hematology, Atlanta, December 9–12, 2017

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Styczynski, J., Tridello, G., Gil, L. et al. Prognostic impact of EBV serostatus in patients with lymphomas or chronic malignancies undergoing allogeneic HCT. Bone Marrow Transplant 54, 2060–2071 (2019) doi:10.1038/s41409-019-0627-9

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