• Mihaja Raberahona, Chloe Wackenheim, Raphaele Germi, Martin Carré, Claude-Eric Bulabois, Anne Thiébaut, Julien Lupo, Touyana Semenova, Jean-Yves Cahn, Patrice Morand, and Olivier Epaulard.
• Infectious Disease Unit, University Hospital, Grenoble, France.
• Transpl Infect Dis. 2016 Dec 1; 18 (6): 889-895.

BackgroundEpstein-Barr virus (EBV) displays oncogenic properties, particularly in the immunocompromised host. Notably, hematopoietic stem cell transplantation (HSCT) recipients with a detectable blood EBV viral load (BEBVL) are considered at higher risk of post-transplant lymphoproliferative diseases (PTLD). Therefore, BEBVL is monitored after HSCT, and preemptive rituximab may be used in patients with high values. However, little is known about post-HSCT BEBVL dynamics, and the threshold that should lead to anti-CD20 therapy is poorly defined.MethodsWe retrospectively analyzed the post-HSCT BEBVL of 332 adult HSCT recipients in our center from 2005 to 2013, including the effect of rituximab.ResultsDetection of BEBVL >100, 1000, 5000, 10 000, and 50 000 copies/mL occurred in, respectively, 77.7%, 69.6%, 37.0%, 27.1%, and 7.5% of the patients after a respective median time of 9, 14, 15, 16, and 14 weeks. No BEBVL threshold was associated with an overall survival difference. Seventy-eight patients received rituximab, with a BEBVL decrease in most. Among patients with detectable BEBVL, long-term survival did not differ in rituximab treated and non-treated, except for patients with BEBVL ≥50 000. Only one case of PTLD was observed.ConclusionsBEBVL is frequently detectable after HSCT, but suggests no strong association with survival. Preemptive rituximab therapy threshold remains to be defined.© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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