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EBV-PTLD, Adenovirus, and CMV in Pediatric Allogeneic Transplants With Alemtuzumab as Part of Pretransplant Conditioning

A Retrospective Single Center Study

Cupit-Link, Margaret C., BS*; Nageswara Rao, Amulya, MD; Warad, Deepti M., MD; Rodriguez, Vilmarie, MD; Khan, Shakila, MD

Journal of Pediatric Hematology/Oncology: November 2018 - Volume 40 - Issue 8 - p e473–e478
doi: 10.1097/MPH.0000000000001138
Online Articles: Original Articles

The risk of viral infections and reactivation occurring in the setting of pediatric allogeneic hematopoietic stem cell transplantation is a concern in the pediatric patient, especially with the use of Alemtuzumab (Campath) as a conditioning agent. The purpose of this study was to determine the incidence of Epstein-Barr virus posttransplant lymphoproliferative disorder (EBV-PTLD), cytomegalovirus (CMV), and adenovirus among pediatric recipients of alemtuzumab at our institution. We found that EBV-PTLD occurred in 2.1% of transplants (1 matched unrelated donor [MUD] recipient), CMV reactivation occurred in 12.5% of transplants (4 MUD and 2 matched related donor [MRD] recipients) with disseminated CMV in 2.1% of cases (1 MRD recipient), and adenovirus infection occurred in 8.3% of the total transplants (2 MUD and 2 MRD recipients). Alemtuzumab continues to be used as a method of graft-versus-host disease and graft failure prevention among pediatric recipients of hematopoietic stem cell transplantation and seems to be safer than previously reported. At our institution, alemtuzumab has not increased the risk for EBV-PTLD, CMV infection, or adenovirus.

*Mayo Medical School

Division of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, MN

The authors declare no conflict of interest.

Reprints: Margaret C. Cupit-Link, BS, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55902 (e-mail:

Received October 20, 2017

Accepted December 7, 2017

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