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

Bone Marrow Transplant. 2019 Dec;54(12):2060-2071. doi: 10.1038/s41409-019-0627-9. Epub 2019 Jul 30.

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Chronic Disease
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hematopoietic Stem Cell Transplantation / methods
  • Herpesvirus 4, Human / pathogenicity*
  • Humans
  • Infant
  • Lymphoma / complications*
  • Lymphoma / mortality
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / mortality
  • Prognosis
  • Survival Analysis
  • Transplantation Conditioning / adverse effects*
  • Transplantation Conditioning / methods
  • Transplantation, Homologous / adverse effects*
  • Transplantation, Homologous / methods
  • Young Adult