{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:53:16Z","timestamp":1781844796675,"version":"3.54.5"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the era of letermovir for cytomegalovirus (CMV) prophylaxis, several centers reported that the incidence of Epstein-Barr virus (EBV) infection were significantly increased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the efficacy and safety of rituximab administration during conditioning regimen following haploidentical hematopoietic stem cell transplantation(haplo-HSCT)in the prevention of post-transplant EBV infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 100 patients with acute leukemia or myelodysplastic syndrome who underwent haplo-HSCT. Patients in observation group(R group) received rituximab (375 mg\/m\u00b2) on day -3 before transplantation due to the presence of donor-specific antibody (MFI \u2265 2000) (n = 25) and patients in control group (C group) did not receive rituximab (n = 75) and donor-specific antibody was low (MFI &amp;lt; 2000). The primary objectives were the incidence of EBV-DNA viremia and PTLD within one-year post-transplantation. Secondary objectives included the incidence of CMV infection, cumulative incidence of acute graft-versus-host disease (aGVHD) and chronic GVHD, 100-day non-relapse mortality (NRM), progression-free survival (PFS), and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No significant differences were observed in baseline characteristics between the two groups except for primary disease. When compared with the C group, patients in R group exhibited a lower cumulative incidence of EBV viremia within one-year post - transplantation (4.00% vs. 22.67%, P\u00a0=\u00a00.049) and a lower incidence of aGVHD (28% vs. 50.67%, P\u00a0=\u00a00.048). There was a trend toward reduction of PTLD in the R group compared with C group (0% vs. 10.67%, P\u00a0=\u00a00.089).There were no significant differences of the incidence of CMV viremia (24% vs. 13.33%, P\u00a0=\u00a00.208), cGVHD (16% vs. 12%, P\u00a0=\u00a00.607), and 100 - day NRM (4.0% vs. 10.67%, P\u00a0=\u00a00.313) between two groups. The 2-year OS rates in the R group and C group were 83.8% \u00b1 0.086% and 81.9% \u00b1 0.050% respectively (P\u00a0=\u00a00.360). The 2-year PFS rates in the R group and C group were 83.8% \u00b1 0.086% and 72.6% \u00b1 0.068% respectively (P\u00a0=\u00a00.360).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combined use of rituximab during the conditioning regimen may be regarded as an effective strategy for preventing EBV reactivation after rATG - based haplo - HSCT in the era of letermovir for CMV prophylaxis.Prospective randomized controlled trials are still required to further validate the reliability of the results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1795239","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:29:50Z","timestamp":1781843390000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The application of rituximab during the conditioning regimen prevents Epstein - Barr virus infection following rATG-based haploidentical hematopoietic stem cell transplantation in the era of letermovir for cytomegalovirus prophylaxis"],"prefix":"10.3389","volume":"17","author":[{"given":"Jinxia","family":"Hao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Xi\u2019an Jiaotong University Hospital","place":["Xi\u2019an, Shaanxi, China"]},{"name":"Department of Hematology, The First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongxin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoning","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.70032","article-title":"Clinically significant EBV infection in allogeneic stem cell transplanted children receiving letermovir as primary CMV prophylaxis","volume":"20","author":"Oikonomopoulou","year":"2025","journal-title":"Transpl Infect Dis"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2025.1639463","article-title":"Increased EBV infection and relapse following haploidentical hematopoietic cell transplantation in the era of letermovir for cytomegalovirus prophylaxis: a propensity score matching analysis","volume":"15","author":"Huang","year":"2025","journal-title":"Front Cell Infect Microbiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s13045-024-01612-y","article-title":"Increased Epstein\u2013Barr virus reactivation following prophylaxis for cytomegalovirus infection after haploidentical haematopoietic stem cell transplantation","volume":"17","author":"Kong","year":"2024","journal-title":"J Hematol Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-021-04433-y","article-title":"Post-transplantation lymphoproliferative disorder after haematopoietic stem cell transplantation","volume":"100","author":"Pegoraro","year":"2021","journal-title":"Ann Hematol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2022.10.023","article-title":"Pre-hematopoietic stem cell transplantation rituximab for Epstein-Barr virus and post-lymphoproliferative disorder prophylaxis in alemtuzumab recipients","volume":"29","author":"Patel","year":"2023","journal-title":"Transplant Cell Ther"},{"key":"B6","article-title":"1994 consensus conference on acute GVHD grading","volume":"15","author":"Przepiorka","year":"1995","journal-title":"Bone Marrow Transplant"},{"key":"B7","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.bbmt.2014.12.001","article-title":"National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. The 2014 diagnosis and staging working group report","volume":"21","author":"Jagasia","year":"2015","journal-title":"Biol Blood Marrow Transplant"},{"key":"B8","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s40164-025-00665-0","article-title":"Epstein-Barr virus infection following allogeneic hematopoietic stem cell transplantation in the era of letermovir for cytomegalovirus prophylaxis","volume":"14","author":"Huang","year":"2025","journal-title":"Exp Hematol Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1080\/2162402x.2016.1139274","article-title":"Rituximab-based treatments followed by adoptive cellular immunotherapy for biopsy-proven EBV-associated post-transplant lymphoproliferative disease in recipients of allogeneic hematopoietic stem cell transplantation","volume":"5","author":"Jiang","year":"2016","journal-title":"Oncoimmunology"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/tid.70124","article-title":"Preemptive rituximab for Epstein-Barr virus reactivation after hematopoietic cell transplantation: Necessary for all","author":"de Souza","year":"2025","journal-title":"Transpl Infect Dis"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1795239\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:29:51Z","timestamp":1781843391000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1795239\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,19]]},"references-count":10,"alternative-id":["10.3389\/fimmu.2026.1795239"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1795239","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,19]]},"article-number":"1795239"}}