Article ; Online: Impact of donor and recipient Epstein-Barr Virus serostatus on outcomes of allogeneic hematopoietic cell transplantation: a systematic review and meta-analysis.
2021 Volume 100, Issue 3, Page(s) 763–777
Abstract: Allogeneic hematopoietic cell transplant (allo-HCT) is a potentially curative therapeutic strategy that showed encouraging long-term outcomes in hematological diseases. A number of factors can influence post-transplant clinical outcomes. While Epstein- ... ...
| Abstract | Allogeneic hematopoietic cell transplant (allo-HCT) is a potentially curative therapeutic strategy that showed encouraging long-term outcomes in hematological diseases. A number of factors can influence post-transplant clinical outcomes. While Epstein-Barr virus (EBV) constitutes a trigger for development of various adverse conditions, no clinical study yet has been powered to assess the effect of EBV serostatus on the clinical outcomes in allo-HCT population. To systematically summarize and analyze the impact of donor and recipient EBV serostatus on transplant outcomes in allo-HCT recipients, meta-analyses were conducted. Selected endpoints were overall survival (OS), relapse-free survival (RFS), relapse incidence (RI), non-relapse mortality (NRM), acute graft-versus-host disease (aGVHD), chronic graft-versus-host disease (cGVHD), and de novo cGVHD. Three studies with 26,650 patients, transplanted for acute leukemias, lymphomas, chronic hematological malignancies, or non-malignant hematological diseases were included in the meta-analysis. In the whole population, with a total of 53,300 donors and recipients, the rate of EBV seropositivity was 85.1%, including 86.6% and 83.6% among transplant recipients and healthy donors, respectively. Donor EBV seropositivity increased the risk of cGVHD by 17%, de novo cGVHD by 14%, and aGHVD by 5%. Recipient EBV seropositivity increased the risk of cGVHD by 12%, de novo cGVHD by 17%; increased NRM by 11%, increased RI by 11%, decreased OS by 14%, and decreased RFS by 11%. In performed meta-analyses, donor and recipient EBV seropositivity was found to have a significant impact on transplant outcomes in patients after allo-HCT. |
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| MeSH term(s) | Adolescent ; Adult ; Aged ; Epstein-Barr Virus Infections/complications ; Epstein-Barr Virus Infections/diagnosis ; Epstein-Barr Virus Infections/epidemiology ; Female ; Graft vs Host Disease/diagnosis ; Graft vs Host Disease/etiology ; Graft vs Host Disease/mortality ; Hematologic Neoplasms/complications ; Hematologic Neoplasms/diagnosis ; Hematologic Neoplasms/epidemiology ; Hematologic Neoplasms/therapy ; Hematopoietic Stem Cell Transplantation/adverse effects ; Hematopoietic Stem Cell Transplantation/mortality ; Hematopoietic Stem Cell Transplantation/statistics & numerical data ; Herpesvirus 4, Human/physiology ; Humans ; Male ; Middle Aged ; Prognosis ; Recurrence ; Seroepidemiologic Studies ; Survival Analysis ; Tissue Donors/statistics & numerical data ; Transplant Recipients/statistics & numerical data ; Transplantation, Homologous/adverse effects ; Transplantation, Homologous/mortality ; Treatment Outcome ; Young Adult |
| Language | English |
| Publishing date | 2021-01-25 |
| Publishing country | Germany |
| Document type | Journal Article ; Meta-Analysis ; Systematic Review |
| ZDB-ID | 1064950-5 |
| ISSN | 1432-0584 ; 0939-5555 ; 0945-8077 |
| ISSN (online) | 1432-0584 |
| ISSN | 0939-5555 ; 0945-8077 |
| DOI | 10.1007/s00277-021-04428-9 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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