The application of rituximab during the conditioning regimen prevents Epstein - Barr virus infection following rATG-based haploidentical hematopoietic stem cell transplantation in the era of letermovir for cytomegalovirus prophylaxis - Report - MDSpire
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The application of rituximab during the conditioning regimen prevents Epstein - Barr virus infection following rATG-based haploidentical hematopoietic stem cell transplantation in the era of letermovir for cytomegalovirus prophylaxis
Utilizing rituximab in the conditioning phase may reduce the risk of EBV infection
Overview
This study investigates the efficacy of rituximab during conditioning for haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in preventing Epstein-Barr virus (EBV) infection. Results indicate a significantly lower incidence of EBV viremia and acute graft-versus-host disease (aGVHD) in patients receiving rituximab compared to those who did not.
Background
EBV reactivation is a common complication following haplo-HSCT, particularly in the context of letermovir prophylaxis for cytomegalovirus (CMV). This study evaluates the role of rituximab in the conditioning regimen to mitigate EBV-related complications post-transplant.
Data Highlights
Outcome
R Group (n=25)
C Group (n=75)
P-value
EBV viremia incidence
4.00%
22.67%
0.049
aGVHD incidence
28%
50.67%
0.048
PTLD incidence
0%
10.67%
0.089
CMV viremia incidence
24%
13.33%
0.208
cGVHD incidence
16%
12%
0.607
100-day NRM
4.0%
10.67%
0.313
2-year OS rate
83.8%
81.9%
0.360
2-year PFS rate
83.8%
72.6%
0.360
Key Findings
Rituximab administration reduced EBV viremia incidence to 4.00% compared to 22.67% in the control group (P = 0.049).
Patients receiving rituximab had a lower incidence of aGVHD (28% vs. 50.67%, P = 0.048).
A trend toward reduced PTLD incidence was observed in the rituximab group (0% vs. 10.67%, P = 0.089).
No significant differences were found in CMV viremia, cGVHD, or 100-day non-relapse mortality between the groups.
2-year overall survival rates were similar between the two groups (83.8% vs. 81.9%, P = 0.360).
2-year progression-free survival rates were also comparable (83.8% vs. 72.6%, P = 0.360).
Clinical Implications
The findings indicate a lower incidence of EBV reactivation in patients receiving rituximab. Further studies are needed to explore the implications of these results.
Conclusion
Rituximab administration during the conditioning phase is associated with a lower incidence of EBV reactivation in haplo-HSCT patients.
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