Department of Pediatric Hematology and Oncology, Jurasz University Hospital, Collegium Medicum UMK Torun, Bydgoszcz, Poland.
Pediatric Hematology Oncology, Ospedale Donna Bambino, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
Bone Marrow Transplant. 2019 Dec;54(12):2060-2071. doi: 10.1038/s41409-019-0627-9. Epub 2019 Jul 30.
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.
在 1997 年至 2016 年间，对 12931 名接受异基因造血细胞移植（allo-HCT）的淋巴瘤或慢性恶性肿瘤患者的供体（D）和受者（R）移植前 EBV 血清状态对移植结果（总体生存、无复发生存、复发发生率、非复发死亡率、急性和慢性 GVHD）的影响进行了分析。多变量分析显示，与 R-/D-移植相比， EBV R+/D+（HR=1.26；p=0.003）、R+/D-（HR=1.21；p=0.044）和 R-/D+（HR=1.21；p=0.048）患者发生慢性 GVHD 的风险增加。其他移植结果无显著性差异；然而，在单变量分析中，与 EBV 阴性受者接受 EBV 阴性供者（EBV R-/D-）的移植物相比，接受 EBV 阳性供者（EBV R+/D+）的移植物的 EBV 阳性患者的移植结果较差：总体生存率（59.6% vs 65.9%）、无复发生存率（51.1% vs 57.5%）、慢性 GVHD 发生率增加（49.5% vs 41.8%）和新发慢性 GVHD 发生率增加（30.5% vs 24.0%）。总之，患有淋巴瘤或慢性恶性肿瘤的 EBV 阴性受者在慢性 GVHD 背景下可以从选择 EBV 阴性供者中获益，而 EBV 阳性受者对供者 EBV 血清状态没有偏好。
