ArticleInternational journal of molecular sciences2023
Pre-Emptive Use of Rituximab in Epstein-Barr Virus Reactivation: Incidence, Predictive Factors, Monitoring, and Outcomes.
Article in International journal of molecular sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 6 citations in OpenAlex.
- Posttransplant rituximab exposure and risk of PTLD in solid organ transplant recipients with EBV DNAemia.Blood neoplasia · 2025Article
- Clinical Spectrum of Epstein Barr Viremia in Hematological Disorders: Case Series and Review of Literature.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025Article
- Article
- Chimeric Antigen Receptor Immunotherapy for Infectious Diseases: Current Advances and Future Perspectives.Pathogens (Basel, Switzerland) · 2025Review
- Genetics and Epigenetics in Acquired Hemophilia A: From Bench to Bedside.Current issues in molecular biology · 2024Review
- Impact of prophylaxis with rituximab on EBV-related complications after allogeneic hematopoietic cell transplantation in children.Frontiers in immunology · 2024Article
- [Clinical value of plasma Epstein-Barr virus DNA monitoring in lymphoproliferative disorders after allogeneic hematopoietic stem cell transplantation in children].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatricsArticle
- Post-transplant lymphoproliferative disorder following multivisceral transplantation: Incidence, risk factors, and outcomes in an adult UK cohort.Intestinal Failure (New York, N.Y.)Article
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Authors and funding
15 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Post-transplant lymphoproliferative disease (PTLD) is a fatal complication of hematopoietic cell transplantation (HCT) associated with the Epstein-Barr virus (EBV). Multiple factors such as transplant type, graft-versus-host disease (GVHD), human leukocyte antigens (HLA) mismatch, patient age, and T-lymphocyte-depleting treatments increase the risk of PTLD. EBV reactivation in hematopoietic cell transplant recipients is monitored through periodic quantitative polymerase chain reaction (Q-PCR) tests. However, substantial uncertainty persists regarding the clinically significant EBV levels for these patients. Guidelines recommend initiating EBV monitoring no later than four weeks post-HCT and conducting it weekly. Pre-emptive therapies, such as the reduction of immunosuppressive therapy and the administration of rituximab to treat EBV viral loads are also suggested. In this study, we investigated the occurrence of EBV-PTLD in 546 HCT recipients, focusing on the clinical manifestations and risk factors associated with the disease. We managed to identify 67,150 viral genomic copies/mL as the cutoff point for predicting PTLD, with 80% sensitivity and specificity. Among our cohort, only 1% of the patients presented PTLD. Anti-thymocyte globulin (ATG) and GVHD were independently associated with lower survival rates and higher treatment-related mortality. According to our findings, prophylactic measures including regular monitoring, pre-emptive therapy, and supportive treatment against infections can be effective in preventing EBV-related complications. This study also recommends conducting EBV monitoring at regular intervals, initiating pre-emptive therapy when viral load increases, and identifying factors that increase the risk of PTLD. Our study stresses the importance of frequent and careful follow-ups of post-transplant complications and early intervention in order to improve survival rates and reduce mortality.
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