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

Bone Marrow Transplantation volume 54, pages 2060–2071 (2019)Cite this article

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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.

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Acknowledgements

The authors thank all EBMT transplant centers for reporting data to the EBMT Registry.

Author information

Authors and Affiliations

  1. Department of Pediatric Hematology and Oncology, Jurasz University Hospital, Collegium Medicum UMK Torun, Bydgoszcz, Poland

    Jan Styczynski

  2. Pediatric Hematology Oncology, Ospedale Donna Bambino, Azienda Ospedaliera Universitaria Integrata, Verona, Italy

    Gloria Tridello & Simone Cesaro

  3. Department of Hematology, Medical University, Poznan, Poland

    Lidia Gil

  4. Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden

    Per Ljungman

  5. Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden

    Per Ljungman

  6. Division of Infectious Diseases, Department of Health Sciences, University of Genova, Ospedale Policlinco San Martino, Genova, Italy

    Malgorzata Mikulska

  7. University College London, London, United Kingdom

    Katherine N. Ward

  8. Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris (AP-HP) and Paris-Est-Créteil University, Creteil, France

    Catherine Cordonnier

  9. Hospital de la Princesa, Madrid, Spain

    Rafael de la Camara

  10. Hadassah University Hospital, Jerusalem, Israel

    Diana Averbuch

  11. EBMT Data Office, Leiden, Netherlands

    Nina Knelange

  12. Hôpital St. Louis, Paris, France

    Gerard Socié

  13. CHU Nantes, Nantes, France

    Patrice Chevallier

  14. Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  15. CHU de Lille, LIRIC, INSERM U995, Université de Lille2, Lille, 59000, France

    Ibrahim Yakoub-Agha

  16. CHU Bordeaux, Hopital Haut-leveque, Pessac, France

    Edouard Forcade

  17. Erasmus MC Cancer Institute, Rotterdam, Netherlands

    Jan Cornelissen

  18. University Hospital Gasthuisberg, Leuven, Belgium

    Johan Maertens

  19. University Medical Centre, Utrecht, Netherlands

    Eefke Petersen

  20. Hopital la Pitié-Salpêtrière, Paris, France

    Stéphanie Nguyen-Quoc

  21. Leiden University Hospital, Leiden, Netherlands

    Hendrik Veelken

  22. Radboud University Medical Centre, Nijmegen, Netherlands

    Nicolaas Schaap

  23. University Hospital, Basel, Switzerland

    Jakob Passweg

  24. Centre Hospitalier Lyon Sud, Lyon, France

    Mauricette Michallet

  25. CHU Lapeyronie, Montpellier, France

    Nathalie Fegueux

  26. Hôpital Jean Minjoz, Besancon, France

    Eric Deconinck

  27. Nottingham University, Nottingham, United Kingdom

    Nigel Russell

  28. Department of Hematology, Medical University, Warsaw, Poland

    Grzegorz Basak

  29. Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany

    Peter Bader

  30. St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom

    Silvia Montoto

  31. University Hospital Eppendorf, Hamburg, Germany

    Nicolaus Kröger

Authors
  1. Jan Styczynski
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  2. Gloria Tridello
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  3. Lidia Gil
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  4. Per Ljungman
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  5. Malgorzata Mikulska
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  6. Katherine N. Ward
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  7. Catherine Cordonnier
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  8. Rafael de la Camara
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  25. Eric Deconinck
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  27. Grzegorz Basak
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  28. Peter Bader
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  29. Silvia Montoto
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  30. Nicolaus Kröger
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  31. Simone Cesaro
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Consortia

on behalf of the Infectious Diseases Working Party EBMT

Contributions

Study design: JS, LG and SC; Data analysis and interpretation: JS, GT, LG, NKn, MMik and PL; Manuscript writing: JS, GT, LG and KNW; Provision of important clinical data: JS, LG, PL, CC, RdlC, DA, GS, PC, DB, IYA, EF, JC, JM, EP, SNQ, HV, NS, JP, MMic, NF, ED, NR, GB, PB, SM, NKr and SC; Microbiology check-up: KNW; Data check-up: NKn and GT; Statistical analysis: GT; Administrative support: JS, NKn and SC; Revision of manuscript: All authors; Final approval: All authors.

Corresponding author

Correspondence to Jan Styczynski.

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The authors declare that they have no conflict of interest.

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Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Results of this study were presented at 59th Annual Meeting of American Society of Hematology, Atlanta, December 9–12, 2017

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Styczynski, J., Tridello, G., Gil, L. et al. Prognostic impact of EBV serostatus in patients with lymphomas or chronic malignancies undergoing allogeneic HCT. Bone Marrow Transplant 54, 2060–2071 (2019). https://doi.org/10.1038/s41409-019-0627-9

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  • DOI: https://doi.org/10.1038/s41409-019-0627-9

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