ArticleBone marrow transplantation2026
Risk factors for EBV reactivation and impact of graft composition following GVHD prophylaxis with rabbit ATG or PTCy.
Article in Bone marrow transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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14 authors.
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Abstract
backgroundEBV reactivation is frequent after allogeneic HCT and can lead to post-transplant lymphoproliferative disorder (PTLD). While ATG and PTCy are established strategies to prevent GVHD, their comparative impact on EBV reactivation remains insufficiently characterized.
methodsWe conducted a retrospective study in patients who received either rabbit ATG or PTCy. Primary endpoints were incidences of positive and high-level EBV DNAemia (≥10⁴ copies/mL). Secondary endpoints were incidence of PTLD, predictive risk factors for EBV reactivation, GVHD, survival, immune reconstitution and response to hepatitis B vaccination.
results286 patients were included; 215 received ATG and 71 PTCy. High-level EBV DNAemia occurred earlier and more frequently after ATG (42.3% vs 22.5%, p < 0.0001). All PTLDs were in ATG recipients. In these, high CD19+ B cell doses ( ≥ 3.88 × 10
conclusionRabbit ATG, high CD19+ content and CD19+/CD8+ ratio in infused grafts are associated with a higher risk of EBV. Novel strategies targeting these patients while preserving immune reconstitution are warranted.
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