Donor Epstein-Barr Virus Status Affects Risk for Graft-vs-Host Disease but Not Survival in Acute Leukemia After HSCT


Key Points

• Donor EBV-seropositive status did not affect overall or relapse-free survival among patients with acute leukemia receiving allogeneic hematopoietic stem cell transplantation.

• Donor EBV-seropositive status was associated with an increased risk for graft-vs-host disease.

Positive donor Epstein-Barr virus (EBV) serostatus increases the risk for graft-vs-host disease but does not affect relapse-free or overall survival among patients with acute leukemia receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT), according to a study from the Acute Leukemia and Infectious Diseases Working Parties of the European Society for Blood and Marrow Transplantation reported by Styczynski et al in the Journal of Clinical Oncology.

Study Details

The study included 11,364 patients who underwent allo-HSCT for acute leukemia between 1997 and 2012. The majority of both donors and recipients were EBV-seropositive; donor/recipient pairings were positive/positive in 75.3% of cases, negative/positive in 9.5%, positive/negative in 6.5%, and negative/negative in 8.7%, respectively.

Survival and Graft-vs-Host Disease

Patients receiving grafts from EBV-seropositive donors had similar overall survival (hazard ratio [HR] = 1.05, P = .23), relapse-free survival (HR = 1.04, P = .31), relapse incidence (HR = 1.03, P = .58), and nonrelapse mortality (HR = 1.05, P = .37) as those receiving grafts from EBV-seronegative donors. In analysis adjusting for confounders, there was an elevated risk for chronic graft-vs-host disease (HR = 1.30, P = .039) in seronegative patients with seropositive donors and an increased risk for acute (HR = 1.24, P = .016) and chronic graft-vs-host disease (HR = 1.43, P < .001) in seropositive patients with seropositive donors. No increased risk for graft-vs-host disease was seen in seropositive patients with seronegative donors.

The investigators concluded: “Our data suggest that donor EBV status significantly influences development of acute and chronic graft-vs-host disease after allo-HSCT.”

Jan Styczynski, MD, PhD, of Nicolaus Copernicus University Torun, Bydgoszcz, Poland, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.