Walti, Laura N.; Mugglin, Catrina; Sidler, Daniel; Mombelli, Matteo; Manuel, Oriol; Hirsch, Hans H.; Khanna, Nina; Mueller, Nicolas; Berger, Christoph; Boggian, Katia; Garzoni, Christian; Neofytos, Dionysios; van Delden, Christian; Hirzel, Cédric; Transplant Cohort Study Stcs, Swiss (2021). Association of Antiviral Prophylaxis and Rituximab Use with Post-transplant Lymphoproliferative Disorders (PTLD): A Nationwide Cohort Study. American journal of transplantation, 21(7), pp. 2532-2542. Wiley-Blackwell 10.1111/ajt.16423
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Post-transplant lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplantation (SOT). Most PTLD cases are associated with Epstein-Barr virus (EBV) infection. The role of antiviral prophylaxis or rituximab therapy for prevention of PTLD in SOT recipients is controversial. In a nationwide cohort, we assessed the incidence, presentation and outcome of histologically-proven PTLD. We included 4'765 patients with a follow-up duration of 23`807 person-years (py). Fifty-seven PTLD cases were identified; 39 (68%) were EBV-positive (EBV+ PTLD). Incidence rates for EBV+ PTLD at 1, 2, and 3 years post-transplant were 3.51; 2.24; 1.75/1'000 py and 0.44; 0.25; 0.29/1'000 py for EBV- PTLD. We did not find an effect of antiviral prophylaxis on early and late EBV+ PTLD occurrence (early EBV+ PTLD: SHR 0.535 [95% CI 0.199-1.436], p=0.264; late EBV+ PTLD: SHR 2.213, [95% CI 0.751-6.521], p=0.150). However, none of the patients (0/191) who received a rituximab-containing induction treatment experienced PTLD, but (57/4'574) patients without rituximab induction developed PTLD. In an adjusted restricted mean survival time model, PTLD-free survival was significantly longer (0.104 years [95% CI 0.077-0.131]) in patients receiving rituximab as induction treatment. This study provides novel data on the association of rituximab induction and reduced risk for PTLD.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension 04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology |
UniBE Contributor: |
Walti, Laura Naëmi, Mugglin, Catrina Andrea, Sidler, Daniel (A), Hirzel, Cédric |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1600-6135 |
Publisher: |
Wiley-Blackwell |
Language: |
English |
Submitter: |
Annelies Luginbühl |
Date Deposited: |
05 Jan 2021 12:10 |
Last Modified: |
29 Mar 2023 23:37 |
Publisher DOI: |
10.1111/ajt.16423 |
PubMed ID: |
33289340 |
BORIS DOI: |
10.48350/149622 |
URI: |
https://boris.unibe.ch/id/eprint/149622 |
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