Journal
BONE MARROW TRANSPLANTATION
Volume 43, Issue 10, Pages 813-816Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/bmt.2008.394
Keywords
acquired aplastic anaemia; allogeneic transplantation; ATG; EBV; immunosuppressive therapy; post-transplant lymphoproliferative disorder
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We reviewed the incidence and risk factors for EBV-related post-transplant lymphoproliferative disorder (EBV-PTLD) in 89 patients with acquired aplastic anaemia (AAA) receiving allogeneic transplants between 1989 and 2006. The overall incidence ofEBV-PT LD was 6.3% (5/89) with no cases in those receiving an allograft for constitutional BM failure syndromes (n=30) during the same period. There was no impact of age, gender, donor status, CMV seropositivity, GVHD and graft cell dose on the occurrence of PTLD. Although both reduced intensity conditioning (RIC) and the prior use of antithymocyte globulin (ATG), as immunosuppressive therapy (IST), were identified as the risk factors for PTLD, only prior use of ATG strongly influenced the development of PTL D with an incidence of 13.38 +/- 5.6% (5/43), compared with none in those not exposed to ATG before transplantation (P=0.01) with a relative risk of 10.39 for each course of prior ATG. This is the first study in patients with AAA documenting that those receiving multiple prior courses of ATG are at the highest risk of developing EBV-PTLD. Bone Marrow Transplantation (2009) 43, 813-816; doi:10.1038/bmt.2008.394; published online 22 December 2008
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