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Blood, 15 October 2006, Vol. 108, No. 8, pp. 2874-2880. Prepublished online as a Blood First Edition Paper on June 27, 2006; DOI 10.1182/blood-2006-03-011791. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-03-011791v1 108/8/2874    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Brunstein, C. G. Articles by Wagner, J. E. Search for Related Content PubMed PubMed Citation Articles by Brunstein, C. G. Articles by Wagner, J. E. Related Collections Immunobiology Neoplasia Transplantation Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Marked increased risk of Epstein-Barr virus-related complications with the addition of antithymocyte globulin to a nonmyeloablative conditioning prior to unrelated umbilical cord blood transplantation Claudio G. Brunstein, Daniel J. Weisdorf, Todd DeFor, Juliet N. Barker, Jakub Tolar, Jo-Anne H. van Burik, and John E. Wagner From the Blood and Marrow Transplant Program, Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Umbilical cord blood (UCB) is increasingly used as an alternative source of hematopoietic stem cells for transplantation for patients who lack a suitable sibling donor. Despite concerns about a possible increased risk of Epstein-Barr virus (EBV) posttransplantation lymphoproliferative disorder (PTLD) after UCB transplantation, early reports documented rates of PTLD comparable to those reported after HLA-matched unrelated marrow myeloablative (MA) transplantations. To further investigate the incidence of EBV PTLD after UCB transplantation and potential risk factors, we evaluated the incidence of EBV-related complications in 335 patients undergoing UCB transplantation with an MA or nonmyeloablative (NMA) preparative regimen. The incidence of EBV-related complications was a 4.5% overall, 3.3% for MA transplantations, and 7% for NMA transplantations. However, the incidence of EBV-related complications was significantly higher in a subset of patients treated with an NMA preparative regimen that included antithymocyte globulin (ATG) versus those that did not (21% vs 2%; P < .01). Nine of 11 patients who developed EBV PTLD were treated with rituximab (anti-CD20 antibody), with the 5 responders being alive and disease free at a median of 26 months. Use of ATG in recipients of an NMA preparative regimen warrants close monitoring for evidence of EBV reactivation and potentially preemptive therapy with rituximab. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. Robin, S. Marque-Juillet, C. Scieux, R. P. de Latour, C. Ferry, V. Rocha, J.-M. Molina, A. Bergeron, A. Devergie, E. Gluckman, et al. Disseminated adenovirus infections after allogeneic hematopoietic stem cell transplantation: incidence, risk factors and outcome Haematologica, September 1, 2007; 92(9): 1254 - 1257. [Abstract] [Full Text] [PDF] E. Juvonen, S. Aalto, J. Tarkkanen, L. Volin, K. Hedman, and T. Ruutu Retrospective evaluation of serum Epstein Barr virus DNA levels in 406 allogeneic stem cell transplant patients Haematologica, June 1, 2007; 92(6): 819 - 825. [Abstract] [Full Text] [PDF] P. Scheinberg, S. H. Fischer, L. Li, O. Nunez, C. O. Wu, E. M. Sloand, J. I. Cohen, N. S. Young, and A. John Barrett Distinct EBV and CMV reactivation patterns following antibody-based immunosuppressive regimens in patients with severe aplastic anemia Blood, April 15, 2007; 109(8): 3219 - 3224. [Abstract] [Full Text] [PDF]

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