Epstein Barr viremia (EBV) and posttransplantation lymphoproliferative disorder (PTLD) are complications of hematopoietic stem cell transplantation (HSCT). The use of antithymocyte globulin (ATG) in recipients of umbilical cord HSCT is a known risk factor for the development of PTLD. In this high-risk population, we implemented an EBV monitoring program with preemptive therapy with rituximab (375 mg/m2 intravenously [i.v.]) for EBV viremia (>1000 copies/mL). Eight of 35 patients treated with a UCB HSCT between 2007 and 2009, developed EBV viremia. Two of 7 developed PTLD (with 1 of the 2 dying of PTLD), despite prophylactic rituximab use. When compared with our previously described cohort where 6 of 30 developed EBV viremia and 5 of 6 patients developed PTLD (with 2 of 5 dying of PTLD), the incidence of PTLD appears to be less when prophylactic rituximab is administered. Despite small numbers, our observations suggest that in this high-risk population, EBV monitoring accompanied by preemptive therapy may reduce the risk of progression to life-threatening PTLD; further follow-up of this cohort and a larger multi-institutional prospective study of this preemptive strategy is warranted. © 2010.
Blaes, A. H., Cao, Q., Wagner, J. E., Young, J. A. H., Weisdorf, D. J., & Brunstein, C. G. (2010). Monitoring and Preemptive Rituximab Therapy for Epstein-Barr Virus Reactivation after Antithymocyte Globulin Containing Nonmyeloablative Conditioning for Umbilical Cord Blood Transplantation. Biology of Blood and Marrow Transplantation, 16(2), 287–291. https://doi.org/10.1016/j.bbmt.2009.10.008