European journal of haematology · 2026
Evolving Patterns of EBV-Associated PTLD After Allogeneic Stem Cell Transplantation: Frequency, Characteristics and Outcomes in a Multicenter GETH-TC Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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García-Cadenas Irene, Guerreiro Manuel, Yañez Lucrecia, Chorao Pedro, Martin Francisco, Suárez-Lledó María, Pérez Ana, Tomás Lucia García, López Javier, Marsal Julia, Romero Noelia, Huguet Maria, Zabalza Amaya, González-Vicent Marta, Vázquez Lourdes, Silva Pablo, Gil Daniel, Micó-Cerdà Mireia, Sánchez Paula, Filaferro Silvia, Balsalobre Pascual, Jiménez-Ubieto Ana, Martino Rodrigo, Piñana J L
Аннотация
BACKGROUND: Epstein-Barr virus-positive post-transplant lymphoproliferative disorder (EBV + PTLD) is a serious complication after allogeneic hematopoietic stem cell transplantation (allo-SCT). Given evolving transplantation practices, updated data are needed.
OBJECTIVE: Multicenter analysis of PTLD epidemiology, clinical characteristics, and outcomes in Spain.
METHODS: Retrospective study across 17 Spanish transplant centers including all proven/probable EBV+ PTLD cases after allo-SCT from January 2000 to June 2023.
RESULTS: Among 14.568 allo-SCTs, 170 PTLD cases were identified (1.2%) peaking in 2010-2017 (2.0%), versus 0.9% in 2000-2009 and 0.7% in 2018-2023. Median onset was 91 days; 75% occurred within 6 months. Proven cases comprised 67%, mostly diffuse large B-cell lymphoma. Advanced stage occurred in 67%, extranodal disease in 22%. Rituximab ± immunosuppression reduction (ISR) was given to 80%, yielding a 62.4% response rate. Responders had superior survival (2-year OS 73.4% vs. 10.7%). EBV-specific cellular therapies were infrequently used. Median follow-up was 97.8 months; 5-year OS 39.6%, with PTLD causing 49% of deaths. Severe hypoalbuminemia, lack of ISR, and rituximab refractoriness predicted worse survival.
CONCLUSIONS: EBV + PTLD frequency has declined in Spain. Prognosis remains poor for rituximab non-responders, highlighting limited access to EBV-specific cellular therapies as an unmet need.
OBJECTIVE: Multicenter analysis of PTLD epidemiology, clinical characteristics, and outcomes in Spain.
METHODS: Retrospective study across 17 Spanish transplant centers including all proven/probable EBV+ PTLD cases after allo-SCT from January 2000 to June 2023.
RESULTS: Among 14.568 allo-SCTs, 170 PTLD cases were identified (1.2%) peaking in 2010-2017 (2.0%), versus 0.9% in 2000-2009 and 0.7% in 2018-2023. Median onset was 91 days; 75% occurred within 6 months. Proven cases comprised 67%, mostly diffuse large B-cell lymphoma. Advanced stage occurred in 67%, extranodal disease in 22%. Rituximab ± immunosuppression reduction (ISR) was given to 80%, yielding a 62.4% response rate. Responders had superior survival (2-year OS 73.4% vs. 10.7%). EBV-specific cellular therapies were infrequently used. Median follow-up was 97.8 months; 5-year OS 39.6%, with PTLD causing 49% of deaths. Severe hypoalbuminemia, lack of ISR, and rituximab refractoriness predicted worse survival.
CONCLUSIONS: EBV + PTLD frequency has declined in Spain. Prognosis remains poor for rituximab non-responders, highlighting limited access to EBV-specific cellular therapies as an unmet need.