Related Experiment Video

Updated: Nov 3, 2025

Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
08:52

Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant

Published on: May 27, 2011

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Risk factors for post-transplant Epstein-Barr virus events in pediatric recipients of hematopoietic stem cell

Pascal R Enok Bonong1, Chantal Buteau2, Michel Duval3

  • 1Department of Social and Preventive Medicine, CHU Sainte-Justine, Université de Montréal, Montreal, QC, Canada.

Pediatric Transplantation
|June 2, 2021
PubMed

Insights

Mycophenolate mofetil (MMF) significantly reduces Epstein-Barr virus (EBV) risks after pediatric stem cell transplants. Donor/recipient EBV status and anti-thymocyte globulin (ATG) increase EBV events, while female sex and ATG use are linked to severe outcomes.

Area of Science:

  • Immunology
  • Virology
  • Hematology

Background:

  • Epstein-Barr virus (EBV) poses a significant risk for severe complications, including post-transplant lymphoproliferative disorder (PTLD), in pediatric patients undergoing allogeneic hematopoietic stem cell transplant (HSCT).
  • Identifying risk factors for EBV-related outcomes is crucial for improving patient management and survival rates post-HSCT.

Purpose of the Study:

  • To investigate the risk factors associated with various post-transplant Epstein-Barr virus (EBV) outcomes in pediatric allogeneic HSCT recipients.
  • To analyze the impact of specific factors, including donor/recipient characteristics and immunosuppressive therapies, on EBV DNAemia, viral load increase, and treatment responses.

Main Methods:

  • Analysis of data from 156 pediatric allogeneic HSCT recipients within the Canadian multicenter TREASuRE study.
  • Utilized Cox and Prentice-Williams-Petersen models to assess risk factors for EBV DNAemia occurrence and recurrence, EBV viral load (EBV-VL) increase, and preemptive rituximab use.

Main Results:

  • Female recipients showed a higher risk of increased EBV viral load (HR=2.83) and rituximab use (HR=3.08).
  • Recipient pre-transplant EBV seropositivity (HR=2.47) and EBV-positive donor grafts (HR=3.53) were associated with EBV DNAemia.
  • Anti-thymocyte globulin (ATG) use strongly correlated with all EBV outcomes (HR=5.33 for rituximab use), while mycophenolate mofetil (MMF) significantly decreased EBV event risk (HR=0.13 for rituximab use).

Conclusions:

  • Mycophenolate mofetil (MMF) use is associated with a significantly reduced risk of all EBV-related outcomes in pediatric allogeneic HSCT.
  • Donor and recipient EBV positivity, along with ATG use, are identified as risk factors for EBV events.
  • Female sex and ATG use are linked to increased risk of severe EBV outcomes, including high viral load and the need for rituximab treatment.
Abstract

Keywords:
EBV viral loadEpstein-Barr virushematopoietic stem cell transplanthuman herpes virus-4pediatricprospective cohortrecurrent eventsrisk factorssex

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