Factors Associated with Post-Transplant Active Epstein-Barr Virus Infection and Lymphoproliferative Disease in Hematopoietic Stem Cell Transplant Recipients: A Systematic Review and Meta-Analysis

Bonong, Pascal Roland Enok; Zahreddine, Monica; Buteau, Chantal; Duval, Michel; Laporte, Louise; Lacroix, Jacques; Alfieri, Caroline; Trottier, Helen

doi:10.3390/vaccines9030288

Cited by 13 publications

(7 citation statements)

References 109 publications

(338 reference statements)

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“…There is a paucity of studies addressing the risk of SNs after UCBT, and data related to SNs in long-term survivors after this procedure are scarce. Few observational studies 6 , 7 , 8 , 14 , 15 reported the occurrence of SNs after UCBT but the sample sizes were too narrow to allow risk comparison with transplants using adult donor grafts.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of subsequent neoplasms after umbilical cord blood transplantation in Europe

et al. 2023

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Subsequent neoplasms (SNs) compromise long-term survivors after hematopoietic cell transplantion. We performed a retrospective analysis of SNs in a cohort of 10358 recipients of umbilical cord blood transplantation (UCBT) reported to Eurocord/EBMT registries from 1988 to 2018. A total of 233 patients developed SNs. Median age at UCBT was 31 years (y) (0.3-69), and 84 were pediatric patients. Indications for UCBT were malignant hematological diseases in 199 patients (85%). Three groups of SNs were observed. Post-transplant lymphoproliferative disorders (PTLD) were reported in 145 patients in a median of 4 months after UCBT. Of these, 9/145 patients died from relapse, 83/145 from PTLD, and 24/145 from transplant-related causes. At last follow-up, 29/145 were alive; 5y-overall survival (OS) after PTLD diagnosis was 21±3%. Acute leukemia / myelodysplasia (AL/MDS) was diagnosed in 23 patients in a median of 28 months after UCBT and included 3 donor-cell AL. Four of 23 patients died from relapse of primary disease, 8/23 from progression of SNs, and 4/23 from TRM. Seven patients were alive at last follow-up; 5y-OS after AL/MDS diagnosis was 36±10%. Solid tumors (ST) were reported in 65 patients in a median of 54 months after UCBT. Most common tumor sites were lung, thyroid, bone and soft tissue. A total of 33/65 patients died (26 due to ST, 6 to relapse of primary disease, 1 cause missing). At last follow-up, 32/65 patients were alive; 5y-OS after the diagnosis of ST was 51±6%. In conclusion, despite their poor outcomes, SNs that occur after UCBT are extremely rare. Identification of associated risk factors and early detection may help to improve OS.

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Section: Discussionmentioning

confidence: 99%

Outcomes of subsequent neoplasms after umbilical cord blood transplantation in Europe

et al. 2023

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“…For many hematological diseases, allogeneic HSCT is the only curative therapeutic option 1,2 . Yet, this therapy is associated with high treatment complications, morbidity and mortality [10][11][12][13] . Several criteria were introduced in clinical practice to predict outcome after allogeneic HSCT to select and advise patients.…”

Section: Discussionmentioning

confidence: 99%

Pre-transplant platelet-to- lymphocyte ratio predicts outcome after allogeneic hematopoietic stem cell transplantation

Woelfinger

Hauptrock

Kriege

et al. 2022

Sci Rep

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For many patients with hematological malignancies such as acute leukemia or myelodysplastic syndrome allogeneic hematopoietic stem cell transplantation (allogeneic HSCT) is the only curative treatment option. Despite the curative potential of this treatment many patients experience relapse of their underlying disease or die due to multiple complications e.g. infections. Risk scores could help to assess the individual prognosis and guide patients and treating physicians to choose between different treatment options. Parameters reflecting the inflammatory status, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR), have been demonstrated to be associated with prognosis and treatment complications in patients with various cancers. In this study, we evaluate pre-HSCT NLR, MLR and PLR as predictive markers in patients undergoing allogeneic HSCT. We demonstrate that a high (> 133) PLR level is associated with better clinical outcome. Patients with high pre-HSCT PLR show a significant better overall survival (p = 0.001), less relapses (p = 0.016), lower non-relapse-mortality (p = 0.022), less transfusions of red blood cells, platelets and fresh frozen plasma (p = 0.000), fewer episodes of fever (p = 0.002), considerably less different antibiotics (p = 0.005), fewer intensive care unit treatment (p = 0.017) and a lower in-hospital mortality (p = 0.024). Pre-HSCT PLR is easy to calculate by daily routine and could help to predict patient outcome after allogeneic HSCT.

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“…Bonong et al found that the use of antithymocyte globulin in HSCT patients is an important risk factor for herpes infection after transplantation. 36 Beswick et al reported that chronic GVHD and cytomegaloviremia were significantly associated with nontuberculous mycobacterial diseases. 37 Likewise, we found that C 0 can be used to monitor the occurrence of adverse reactions as the level of C 0 significantly increases at the time of infection.…”

Section: Discussionmentioning

confidence: 99%

Influential Factors and Efficacy Analysis of Tacrolimus Concentration After Allogeneic Hematopoietic Stem Cell Transplantation in Children with β-Thalassemia Major

Li¹,

Lu²,

Zhou³

et al. 2021

PGPM

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Purpose To analyze factors influencing tacrolimus (TAC) trough concentration (C 0 ) in β-thalassemia major (β-TM) pediatric patients after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) and to investigate the effects of genotype polymorphism and drug-drug interactions on TAC trough concentration in children with β-TM. Furthermore, to analyze the correlation between TAC C 0 and efficacy and adverse reactions. Patients and Methods Prospectively collection of demographic information and details of combined treatment of patients with β-TM receiving HSCT, and genotypes of CYP3A4, CYP3A5, and ABCB1 (rs1045642, rs1128503, rs2032582) were obtained for each patient. Univariate analysis and multiple linear regression analysis were used to investigate influencing factors on TAC C 0 . The impact of different genotypes and the co-administration of azole antifungal drugs on β-TM patients receiving TAC were evaluated, together with the correlation between acute graft-versus-host disease (aGVHD), infection, and liver injury of TAC C 0 . Results A total of 46 patients with 587 concentration data were included. The multiple linear regression results showed that the patient’s sex, weight, postoperative time, hemoglobin, platelet count, serum cystatin C, and combined voriconazole were independent influencing factors of the infusion trough concentration/daily dose, C 0 /D iv . Age, body surface area, postoperative time, co-administration of voriconazole, and CYP3A4*18B are independent influencing factors of C 0 /D po . Group comparisons showed that voriconazole can affect TAC C 0 administered intravenously (IV) and orally in β-TM pediatric patients, while patient genotype can affect TAC C 0 during oral administration. TAC C 0 does not correlate with aGVHD or liver injury, but infection may be associated with TAC C 0 . Conclusion The concentration of TAC should be closely monitored when co-administered with voriconazole. It is worth considering that the influence of genotype on the trough concentration of oral TAC and individualized drug administration warrant investigation. Finally, this study indicated that C 0 is not suitable as an indicator of the efficacy of TAC.

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Factors Associated with Post-Transplant Active Epstein-Barr Virus Infection and Lymphoproliferative Disease in Hematopoietic Stem Cell Transplant Recipients: A Systematic Review and Meta-Analysis

Cited by 13 publications

References 109 publications

Outcomes of subsequent neoplasms after umbilical cord blood transplantation in Europe

Outcomes of subsequent neoplasms after umbilical cord blood transplantation in Europe

Pre-transplant platelet-to- lymphocyte ratio predicts outcome after allogeneic hematopoietic stem cell transplantation

Influential Factors and Efficacy Analysis of Tacrolimus Concentration After Allogeneic Hematopoietic Stem Cell Transplantation in Children with β-Thalassemia Major

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