Monitoring and Preemptive Rituximab Therapy for Epstein-Barr Virus Reactivation after Antithymocyte Globulin Containing Nonmyeloablative Conditioning for Umbilical Cord Blood Transplantation

Anne H. Blaes; Qing Cao; John E. Wagner; Jo Anne H Young; Daniel J. Weisdorf; Claudio G. Brunstein

doi:10.1016/j.bbmt.2009.10.008

Monitoring and Preemptive Rituximab Therapy for Epstein-Barr Virus Reactivation after Antithymocyte Globulin Containing Nonmyeloablative Conditioning for Umbilical Cord Blood Transplantation

Anne H. Blaes, Qing Cao, John E. Wagner, Jo Anne H Young, Daniel J. Weisdorf, Claudio G. Brunstein

Research output: Contribution to journal › Article › peer-review

67 Scopus citations

Abstract

Epstein Barr viremia (EBV) and posttransplantation lymphoproliferative disorder (PTLD) are complications of hematopoietic stem cell transplantation (HSCT). The use of antithymocyte globulin (ATG) in recipients of umbilical cord HSCT is a known risk factor for the development of PTLD. In this high-risk population, we implemented an EBV monitoring program with preemptive therapy with rituximab (375 mg/m² intravenously [i.v.]) for EBV viremia (>1000 copies/mL). Eight of 35 patients treated with a UCB HSCT between 2007 and 2009, developed EBV viremia. Two of 7 developed PTLD (with 1 of the 2 dying of PTLD), despite prophylactic rituximab use. When compared with our previously described cohort where 6 of 30 developed EBV viremia and 5 of 6 patients developed PTLD (with 2 of 5 dying of PTLD), the incidence of PTLD appears to be less when prophylactic rituximab is administered. Despite small numbers, our observations suggest that in this high-risk population, EBV monitoring accompanied by preemptive therapy may reduce the risk of progression to life-threatening PTLD; further follow-up of this cohort and a larger multi-institutional prospective study of this preemptive strategy is warranted.

Original language	English (US)
Pages (from-to)	287-291
Number of pages	5
Journal	Biology of Blood and Marrow Transplantation
Volume	16
Issue number	2
DOIs	https://doi.org/10.1016/j.bbmt.2009.10.008
State	Published - Feb 2010

Bibliographical note

Funding Information:
Financial disclosure: This work was supported in part by grants from the National Cancer Institute PO1-CA65493 (J.E.W., C.G.B) and the Children's Cancer Research Fund (J.E.W.).

Keywords

Allo SCT
MMF
Pediatric
Pharmacokinetics

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Blaes, A. H., Cao, Q., Wagner, J. E., Young, J. A. H., Weisdorf, D. J., & Brunstein, C. G. (2010). Monitoring and Preemptive Rituximab Therapy for Epstein-Barr Virus Reactivation after Antithymocyte Globulin Containing Nonmyeloablative Conditioning for Umbilical Cord Blood Transplantation. Biology of Blood and Marrow Transplantation, 16(2), 287-291. https://doi.org/10.1016/j.bbmt.2009.10.008

Monitoring and Preemptive Rituximab Therapy for Epstein-Barr Virus Reactivation after Antithymocyte Globulin Containing Nonmyeloablative Conditioning for Umbilical Cord Blood Transplantation. / Blaes, Anne H.; Cao, Qing ; Wagner, John E. et al.
In: Biology of Blood and Marrow Transplantation, Vol. 16, No. 2, 02.2010, p. 287-291.

Research output: Contribution to journal › Article › peer-review

Blaes, AH , Cao, Q , Wagner, JE , Young, JAH , Weisdorf, DJ & Brunstein, CG 2010, 'Monitoring and Preemptive Rituximab Therapy for Epstein-Barr Virus Reactivation after Antithymocyte Globulin Containing Nonmyeloablative Conditioning for Umbilical Cord Blood Transplantation', Biology of Blood and Marrow Transplantation, vol. 16, no. 2, pp. 287-291. https://doi.org/10.1016/j.bbmt.2009.10.008

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Monitoring and Preemptive Rituximab Therapy for Epstein-Barr Virus Reactivation after Antithymocyte Globulin Containing Nonmyeloablative Conditioning for Umbilical Cord Blood Transplantation

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