{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:22:38Z","timestamp":1787498558885,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In allogeneic HCT recipients, risk factors for PTLD and EBV end\u2010organ diseases are well established. Therefore, weekly monitoring of EBV reactivation with quantitative PCR is indicated for patients at risk. Although based on uncontrolled studies and supported by moderate strength of evidence, preemptive rituximab has been recommended in cases of EBV reactivation, without a clearly defined EBV DNAemia threshold. Rituximab is known to be associated with prolonged B\u2010cell depletion and secondary hypogammaglobulinemia, resulting in an increased risk of infectious complications and poor vaccine responses for an extended period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective single\u2010center study, we evaluated the safety and effectiveness of immunosuppression (IS) reduction as the first approach in EBV reactivation in 328 HCT recipients, limiting the introduction of rituximab to patients who did not respond to IS reduction or who developed EBV end\u2010organ disease or PTLD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During follow\u2010up, 178 patients experienced EBV reactivation, with a cumulative incidence of 54.6%. Among these, four patients developed EBV encephalitis (2.2%), and no cases of PTLD were identified. Rituximab was administered to only 12 patients (6.7%). In multivariate analysis, EBV reactivation was significantly associated with chronic GVHD, which may be related to EBV reactivation itself, rapid IS withdrawal, or both. EBV reactivation did not adversely affect non\u2010relapse mortality or overall survival in this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IS reduction as the first\u2010line approach to EBV reactivation was safe and effective in most patients with increasing EBV DNAemia. Consequently, rituximab was required in fewer than 10% of cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70124","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T08:46:06Z","timestamp":1762159566000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Preemptive Rituximab for Epstein\u2013Barr Virus Reactivation After Hematopoietic Cell Transplantation: Necessary for All?"],"prefix":"10.1111","volume":"28","author":[{"given":"Anna Beatriz Coelho","family":"de Souza","sequence":"first","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anderson Jo\u00e3o","family":"Simione","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cl\u00e1udia Ferrari","family":"dos Santos","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iago","family":"Colturato","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Rodrigues","family":"Barbieri","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Ribeiro","family":"do Prado Moreno","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian Per\u00edlio","family":"Zanetti","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila Cibele Serra","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika Rodrigues Pontes","family":"Delattre","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Silva","family":"Santos","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mair Pedro","family":"de Souza","sequence":"additional","affiliation":[{"name":"HCT Program Funda\u00e7\u00e3o Hospital Amaral Carvalho  Ja\u00fa Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verg\u00edlio A. 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