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Applying Rituximab During the Conditioning Regimen Prevents Epstein–Barr Virus Infection Following Allogeneic Hematopoietic Stem Cell Transplant in a Children’s Cohort: A Retrospective Case–Control Study
INTRODUCTION: Since hematopoietic stem cell transplant (HSCT) is an important therapy for malignant and non-malignant pediatric diseases, improving transplant-related mortality remains a challenge. Currently, rituximab, a monoclonal antibody of anti-CD20, is widely used for several post-HSCT complic...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505124/ https://www.ncbi.nlm.nih.gov/pubmed/37470925 http://dx.doi.org/10.1007/s40121-023-00841-x |
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author | Ruan, Yongsheng Chen, Libai Luo, Tingting Xie, Danfeng Cao, Wei Liu, Xuan Liu, Qiujun Xiao, Yuhua Wu, Cuiling Wen, Jianyun Li, Juan Meng, Jiangnan Wu, Xuedong Feng, Xiaoqin |
author_facet | Ruan, Yongsheng Chen, Libai Luo, Tingting Xie, Danfeng Cao, Wei Liu, Xuan Liu, Qiujun Xiao, Yuhua Wu, Cuiling Wen, Jianyun Li, Juan Meng, Jiangnan Wu, Xuedong Feng, Xiaoqin |
author_sort | Ruan, Yongsheng |
collection | PubMed |
description | INTRODUCTION: Since hematopoietic stem cell transplant (HSCT) is an important therapy for malignant and non-malignant pediatric diseases, improving transplant-related mortality remains a challenge. Currently, rituximab, a monoclonal antibody of anti-CD20, is widely used for several post-HSCT complications. However, few studies have focused on the application of rituximab before HSCT. METHODS: We conducted a retrospective case–control study from January 2019 to July 2021 to determine this effect in a single center. Forty-eight patients were included in the rituximab group, with a one-to-one ratio matched to the control group. RESULTS: Both the occurrence rate and cumulative incidence rate of Epstein–Barr virus (EBV) infection were significantly lower in the rituximab group than in the without-rituximab group (10.4% vs. 33.3%, p = 0.014 and 12.2% vs. 39.3% p = 0.0026, respectively). Furthermore, without the application of rituximab was identified as a risk factor for post-HSCT EBV infection via both univariate [hazard ratio (HR) = 4.17, 95%CI (1.52–11.43), p = 0.005] and multivariate analyses [HR = 4.65, 95%CI (1.66–13.0), p = 0.003]. Although the overall survival (OS) probability of the rituximab group was comparable to the without-rituximab group, a markedly improved OS of the rituximab group was found in the malignant disease subgroup (78.9% vs. 42.1%, p = 0.032). The outcomes of graft-versus-host disease, neutrophil and platelet engraftment, other viral infections, and the reconstitution of lymphocytes showed no significant differences between the two groups. CONCLUSIONS: The administration of rituximab before HSCT may prevent EBV infection following HSCT. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40121-023-00841-x. |
format | Online Article Text |
id | pubmed-10505124 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-105051242023-09-18 Applying Rituximab During the Conditioning Regimen Prevents Epstein–Barr Virus Infection Following Allogeneic Hematopoietic Stem Cell Transplant in a Children’s Cohort: A Retrospective Case–Control Study Ruan, Yongsheng Chen, Libai Luo, Tingting Xie, Danfeng Cao, Wei Liu, Xuan Liu, Qiujun Xiao, Yuhua Wu, Cuiling Wen, Jianyun Li, Juan Meng, Jiangnan Wu, Xuedong Feng, Xiaoqin Infect Dis Ther Original Research INTRODUCTION: Since hematopoietic stem cell transplant (HSCT) is an important therapy for malignant and non-malignant pediatric diseases, improving transplant-related mortality remains a challenge. Currently, rituximab, a monoclonal antibody of anti-CD20, is widely used for several post-HSCT complications. However, few studies have focused on the application of rituximab before HSCT. METHODS: We conducted a retrospective case–control study from January 2019 to July 2021 to determine this effect in a single center. Forty-eight patients were included in the rituximab group, with a one-to-one ratio matched to the control group. RESULTS: Both the occurrence rate and cumulative incidence rate of Epstein–Barr virus (EBV) infection were significantly lower in the rituximab group than in the without-rituximab group (10.4% vs. 33.3%, p = 0.014 and 12.2% vs. 39.3% p = 0.0026, respectively). Furthermore, without the application of rituximab was identified as a risk factor for post-HSCT EBV infection via both univariate [hazard ratio (HR) = 4.17, 95%CI (1.52–11.43), p = 0.005] and multivariate analyses [HR = 4.65, 95%CI (1.66–13.0), p = 0.003]. Although the overall survival (OS) probability of the rituximab group was comparable to the without-rituximab group, a markedly improved OS of the rituximab group was found in the malignant disease subgroup (78.9% vs. 42.1%, p = 0.032). The outcomes of graft-versus-host disease, neutrophil and platelet engraftment, other viral infections, and the reconstitution of lymphocytes showed no significant differences between the two groups. CONCLUSIONS: The administration of rituximab before HSCT may prevent EBV infection following HSCT. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40121-023-00841-x. Springer Healthcare 2023-07-20 2023-08 /pmc/articles/PMC10505124/ /pubmed/37470925 http://dx.doi.org/10.1007/s40121-023-00841-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Ruan, Yongsheng Chen, Libai Luo, Tingting Xie, Danfeng Cao, Wei Liu, Xuan Liu, Qiujun Xiao, Yuhua Wu, Cuiling Wen, Jianyun Li, Juan Meng, Jiangnan Wu, Xuedong Feng, Xiaoqin Applying Rituximab During the Conditioning Regimen Prevents Epstein–Barr Virus Infection Following Allogeneic Hematopoietic Stem Cell Transplant in a Children’s Cohort: A Retrospective Case–Control Study |
title | Applying Rituximab During the Conditioning Regimen Prevents Epstein–Barr Virus Infection Following Allogeneic Hematopoietic Stem Cell Transplant in a Children’s Cohort: A Retrospective Case–Control Study |
title_full | Applying Rituximab During the Conditioning Regimen Prevents Epstein–Barr Virus Infection Following Allogeneic Hematopoietic Stem Cell Transplant in a Children’s Cohort: A Retrospective Case–Control Study |
title_fullStr | Applying Rituximab During the Conditioning Regimen Prevents Epstein–Barr Virus Infection Following Allogeneic Hematopoietic Stem Cell Transplant in a Children’s Cohort: A Retrospective Case–Control Study |
title_full_unstemmed | Applying Rituximab During the Conditioning Regimen Prevents Epstein–Barr Virus Infection Following Allogeneic Hematopoietic Stem Cell Transplant in a Children’s Cohort: A Retrospective Case–Control Study |
title_short | Applying Rituximab During the Conditioning Regimen Prevents Epstein–Barr Virus Infection Following Allogeneic Hematopoietic Stem Cell Transplant in a Children’s Cohort: A Retrospective Case–Control Study |
title_sort | applying rituximab during the conditioning regimen prevents epstein–barr virus infection following allogeneic hematopoietic stem cell transplant in a children’s cohort: a retrospective case–control study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505124/ https://www.ncbi.nlm.nih.gov/pubmed/37470925 http://dx.doi.org/10.1007/s40121-023-00841-x |
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