ArticleBone marrow transplantation2026
Incidence and risk factors of Epstein-Barr virus infection and post-transplant lymphoproliferative disorder in paediatric haploidentical allogeneic hematopoietic stem cell transplantation.
Xin Yee Chiew, Lu Bai, Hui-Fang Wang, Feng Zhang, Pan Suo, Guan-Hua Hu, Ying-Xi Zuo, Yu-Qian Sun, Xiao-Dong Mo, Yu Wang and 4 more
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In one paragraphArticle 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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5 · Who and what moneyAuthors and funding
14 authors.
Xin Yee ChiewBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.ORCID http://orcid.org/0000-0003-1770-4920 Lu BaiBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.
Hui-Fang WangBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.
Feng ZhangBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.
Pan SuoBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.
Guan-Hua HuBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.
Ying-Xi ZuoBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.
Yu-Qian SunBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.ORCID http://orcid.org/0000-0003-1856-2231 Xiao-Dong MoBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.ORCID http://orcid.org/0000-0002-9881-7945 Yu WangBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.ORCID http://orcid.org/0000-0003-1253-7465 Lan-Ping XuBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.ORCID http://orcid.org/0000-0002-0267-1081 Xiao-Hui ZhangBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.ORCID http://orcid.org/0000-0003-4730-256X Xiao-Jun HuangBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China.ORCID http://orcid.org/0000-0002-2145-6643 Yi-Fei ChengBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China. yifeicheng1999@vip.sina.cn.ORCID http://orcid.org/0000-0003-2894-9034 Funding
No grant is acknowledged in the PubMed record.
6 · The paper itselfAbstract
Epstein-Barr virus (EBV) reactivation after haploidentical stem cell transplant (haplo-HSCT) is a serious complication, which sometimes progresses to post-transplant lymphoproliferative disorder (PTLD). We retrospectively analyzed 448 pediatric patients ( ≤ 18 years) undergoing anti-thymocyte globulin (ATG)-based haplo-HSCT with letermovir prophylaxis at Peking University People's Hospital (Oct 2022-Oct 2025), using a 1:3 propensity score-matched design. EBV viremia and PTLD incidences were 12.4% and 4.9%. Multivariate analysis showed prior Chimeric Antigen Receptor (CAR) T-cell therapy (Hazard ratio (HR) = 2.040, 95% CI 1.061-3.920; p = 0.033) and Cytomegalovirus (CMV) viremia preceding EBV viremia (HR = 6.075, 95% CI 3.377-10.928; p < 0.001) were risk factors for EBV viremia. The PTLD risk was higher with a total body irradiation (TBI)-based conditioning regimen (HR = 1.917, 95% CI 0.980-3.750; p = 0.050). Overall survival did not differ between groups (EBV + : 92.9% vs. EBV-: 96.4%; p = 0.10), but event-free survival was inferior in EBV-infected patients (86.6% vs. 94.6%; p = 0.004). Chronic graft-versus-host disease (17.0% vs. 6.5%; p < 0.001) and transplant-related mortality (7.1% vs. 2.1%; p = 0.005) were significantly higher in the EBV viremia cohort. EBV reactivation and PTLD pose serious challenges, and risk factors include TBI conditioning, prior CAR-T therapy, and CMV viremia preceding EBV viremia. Preemptive cytotoxic T lymphocyte therapy may benefit high-risk patients.
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