Single dose versus multiple doses of rituximab for preemptive therapy of Epstein–Barr virus reactivation after hematopoietic cell transplantation

Tania Jain, Heidi E. Kosiorek, Thomas E. Grys, Shu Ting Kung, Vishal S. Shah, Jeffrey A. Betcher, James L. Slack, Jose F. Leis, Nandita Khera, Pierre Noel, Jeanne M. Palmer, Lisa Z. Sproat

Research output: Contribution to journalArticle

Abstract

Epstein–Barr virus (EBV) reactivation is an unresolved medical issue after allogeneic hematopoietic stem cell transplantation (HSCT). Rituximab treatment is recommended for EBV reactivation after HSCT but the number of doses of rituximab to use is unclear. In this study, risk factors and outcomes of patients who needed 1 dose vs >1 doses of preemptive rituximab to clear EBV viremia were compared. A higher viral load was more likely to be associated with higher doses of rituximab. Patients whose EBV viremia cleared with 1 dose of rituximab were more likely to have a preceding reduction of immunosuppression. Overall survival (OS) in these 2 cohorts was not different (18.7 vs 26.6 months, respectively, p =.96). Since rituximab can have side effects and is fairly costly, a predictive model to determine the number of rituximab doses using viral load would be a useful and cost-effective manner to utilize rituximab for this indication.

Original languageEnglish (US)
Pages (from-to)110-117
Number of pages8
JournalLeukemia and Lymphoma
Volume60
Issue number1
DOIs
StatePublished - Jan 2 2019
Externally publishedYes

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Cell Transplantation
Viruses
Viremia
Hematopoietic Stem Cell Transplantation
Therapeutics
Viral Load
Rituximab
Immunosuppression
Cell Count
Costs and Cost Analysis
Survival

Keywords

  • allogeneic stem cell transplantation
  • Epstein–Barr virus
  • rituximab

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Single dose versus multiple doses of rituximab for preemptive therapy of Epstein–Barr virus reactivation after hematopoietic cell transplantation. / Jain, Tania; Kosiorek, Heidi E.; Grys, Thomas E.; Kung, Shu Ting; Shah, Vishal S.; Betcher, Jeffrey A.; Slack, James L.; Leis, Jose F.; Khera, Nandita; Noel, Pierre; Palmer, Jeanne M.; Sproat, Lisa Z.

In: Leukemia and Lymphoma, Vol. 60, No. 1, 02.01.2019, p. 110-117.

Research output: Contribution to journalArticle

Jain, T, Kosiorek, HE, Grys, TE, Kung, ST, Shah, VS, Betcher, JA, Slack, JL, Leis, JF, Khera, N, Noel, P, Palmer, JM & Sproat, LZ 2019, 'Single dose versus multiple doses of rituximab for preemptive therapy of Epstein–Barr virus reactivation after hematopoietic cell transplantation', Leukemia and Lymphoma, vol. 60, no. 1, pp. 110-117. https://doi.org/10.1080/10428194.2018.1459603
Jain, Tania ; Kosiorek, Heidi E. ; Grys, Thomas E. ; Kung, Shu Ting ; Shah, Vishal S. ; Betcher, Jeffrey A. ; Slack, James L. ; Leis, Jose F. ; Khera, Nandita ; Noel, Pierre ; Palmer, Jeanne M. ; Sproat, Lisa Z. / Single dose versus multiple doses of rituximab for preemptive therapy of Epstein–Barr virus reactivation after hematopoietic cell transplantation. In: Leukemia and Lymphoma. 2019 ; Vol. 60, No. 1. pp. 110-117.
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