The Clinical Analysis Of EBV Reactivation And Post-transplantation Lymphoproliferative Disease Followed Allo-HSCT

Part1.The analysis of related factors of EBV reactivation followedallo-HSCTObjective: Toexplore the situation of EBV reactivation followed allo-HSCT, and thehigh frequency and risk factors about EBV reactivation,to support the prevention andtherapy for EBV reactivation after allo-HSCT.Method: The retrospectively analysis of294patients,who reviewed the allo-HSCT inSoochow University affiliated first hospital between Jan2013to Sept2013, all the patientswere followed up to Oct2013. The analysis of correlation between EBV reactivation andpatients’ primary disease, the preprocessing way, source of stem cells,anti-thymocyteglobulin use(ATG),HLA type, blood type, GVHD phase, etc.Results:1. For the294patients accepted the allo-HSCT,the cumulative incidence ofEBV reactivation was36.5%,the median time of reactivation was58d (range25-260d).2.EBV reactivation was associated with age, primary disease（AML or ALL）,sourceof stem cells, ATGuse, HLA type, and GVHD phase in univariate factor Logistic analyses(P <0.05), while the gender, primary disease, blood type make no significant difference inEBV reactivation.but multiple factor analyses shows that just ATGuse, HLA type, andGVHD were significant.Conclusion:The incidence of EBV reactivation after allo-HSCT was high, mainlyassociated with age, HLA type, ATGuse, and GVHD. Part2The clinical analysis of PTLD after EBV reactivationfollowed allo-HSCTObjective:To improve the diagnosis and therapy of PTLD by analyzing the clinicalfeatures of PTLD.Method:The analysis of75patients presented with EBV reactivation after allo-HSCTwere analyzed between Jan2013to Sep2013, all the patients were followed up to Oct2013. The incidence, clinical features, and patient survival situation of PTLD wereinvestigated.Results:From the75patients,6developed PTLD, of the2PTLD patents that did notreceive the rituximab, and died of MODS, Other4both survived,4of1patient receivedantiviral therapy, the other3both received the rituximab as the preemptive treatment(Rituximab375mg/m2intravenous drip weekly for2to4times), the median survival timewas80.5d (range8-210d).Conclusion:PTLD was a heterogeneity disease that rapidly developed, and causedhigh mortality, preemptive rituximab could reduce the mortality rate.