Epstein-Barr Virus Reactivation and PTLD in Pediatric Haploidentical HSCT: Incidence, Risks, and Clinical Outcomes

Highlight

– Epstein-Barr virus (EBV) reactivation occurred in 12.4% and post-transplant lymphoproliferative disorder (PTLD) in 4.9% of pediatric haploidentical HSCT recipients.
– Prior CAR-T therapy and preceding cytomegalovirus (CMV) viremia are independent risk factors for EBV viremia.
– Total body irradiation (TBI)-based conditioning associates with increased PTLD risk.
– EBV reactivation correlates with higher chronic graft-versus-host disease (GVHD) incidence and transplant-related mortality, despite no significant difference in overall survival.
– Preemptive cytotoxic T lymphocyte therapy may improve outcomes in high-risk pediatric patients.

Study Background