Clinical analysis of Epstein Barr virus infection after allogeneic hematopoietic stem cell transplantation

Objective To analyze the prevalence of Epstein Barr virus (EBV) infection in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT), and provide evidence for the prevention and treatment of EBV infection after allo-HSCH. Methods A total of 137 patients who underwent allogeneic hematopoietic stem cell transplantation in the Affiliated Hospital of Xuzhou Medical University from December 1, 2014 to January 31, 2019 were enrolled and their clinical data were retrospectively analyzed. The incidence of EBV infection after allo-HSCT was calculated, and the risk factors of EBV infection were analyzed. Results Among the patients, there were 72 men and 65 women, with a median age of 35 (18 to 59) years. A total of 77 patients presented EBV infection, with a one-year cumulative incidence of EBV infection of 56.2% and a median time of 55 (17 to 257) days. Furthermore, EBV infection occurred in 66 patients within 100 days after transplantation, which accounted for 85.71% of all patients with EBV infection. PTLD occurred in 3 patients, with a cumulative incidence of 2.2%. The infection rate of EBV-DNA positive patients before transplantation (70.6%) was higher than that of EBV-DNA negative patients (54.2%), without statistical difference (P=0.202). According to univariate and multivariate analyses, anti-thymocyte globulin (ATG), HLA-mismatch HSCT, cGVHD and CMV reactivation were the independent risk factors for EBV infection after allo-HSCT. Conclusions Epstein Barr virus infection is a common complication in patients with allogeneic hematopoietic stem cell transplantation. ATG, HLA-mismatch HSCT, cGVHD and CMV reactivation are the independent risk factors for EBV infection.