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

Styczynski, J.; Tridello, G.; Gil, L.; Ljungman, P.; Mikulska, M.; Ward, K. N.; Cordonnier, C.; de la Camara, R.; Averbuch, D.; Knelange, N.; Socie, G.; Chevallier, P.; Blaise, D.; Yakoub-Agha, I.; Forcade, E.; Cornelissen, J.; Maertens, J.; Petersen, E.; Nguyen-Quoc, S.; Veelken, H.; Schaap, N.; Passweg, J.; Michallet, M.; Fegueux, N.; Deconinck, E.; Russell, N.; Basak, G.; Bader, P.; Montoto, S.; Kroger, N.; Cesaro, S.

doi:10.1038/s41409-019-0627-9

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.

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

Styczynski J.;Tridello G.;Gil L.;Ljungman P.;Mikulska M.;Ward K. N.;Cordonnier C.;de la Camara R.;Averbuch D.;Knelange N.;Socie G.;Chevallier P.;Blaise D.;Yakoub-Agha I.;Forcade E.;Cornelissen J.;Maertens J.;Petersen E.;Nguyen-Quoc S.;Veelken H.;Schaap N.;Passweg J.;Michallet M.;Fegueux N.;Deconinck E.;Russell N.;Basak G.;Bader P.;Montoto S.;Kroger N.;Cesaro S.

2019-01-01

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.