Epstein-Barr virus (EBV) infection and associated post transplantation lymphoproliferative disease (PTLD) in hematopoietic stem cell transplantation (HSCT): a prevalence based systematic review and meta-analysis on global epidemiology
Mustafa, Awais Khandker, Shahad Saif Farwa, Umme Saeed, Muhammad Hamza Sarfraz, Muhammad Manan, Abdul Gillani, Hifza Ishtiaq Akbar, Amna Ejaz, Khawaja Faizan Atta, Asma
Mustafa, Awais
Khandker, Shahad Saif
Farwa, Umme
Saeed, Muhammad Hamza
Sarfraz, Muhammad
Manan, Abdul
Gillani, Hifza Ishtiaq
Akbar, Amna
Ejaz, Khawaja Faizan
Atta, Asma
Affiliation
The Dudley Group NHS Foundation Trust; Worcestershire Acute Hospitals et al
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Publication date
2025-09-08
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Abstract
INTRODUCTION: Hematopoietic stem cell transplantation (HSCT) is a widely used transplant method for different cancerous and non-cancerous conditions, particularly when conventional treatments fail. Again, Epstein-Barr Virus (EBV), one of the major contributors to gastric carcinoma can cause post-transplantation lymphoproliferative disease (PTLD) after transplantations. However, the global prevalence of EBV infection and associated PTLD in HSCT recipients is yet to be determined.
METHODS: This research examined 33 studies selected from 941 articles across three databases (i.e. ScienceDirect, PubMed, and Google Scholar) to investigate the global epidemiology of EBV infection and associated PTLD in HSCT patients.
RESULTS: The overall prevalence was calculated primarily as 27.0%; 95% CI: 24.5-29.5, and 23.7%; 95% CI: 19.3-28.3 after removing outlier studies. The analyzed studies were of high quality. Among different continents, North America was determined to have the highest prevalence rate (33.3%; 95%CI: 12.5-54.1) followed by Europe (27.8%; 95%CI: 23.3-32.2), and Asia (20.7%; 95%CI: 17.4-23.9).
CONCLUSION: This investigation highlights the need for early detection of EBV infection and associated PTLD, personalized treatment strategies, and continued research into the condition's underlying mechanisms. Addressing these aspects can enhance outcomes for HSCT patients and contribute to advancements in transplant medicine.
REGISTRATION: PROSPERO (CRD420250583221).
Citation
Mustafa A, Khandker SS, Farwa U, Saeed MH, Sarfraz M, Manan A, Gillani HI, Akbar A, Ejaz KF, Atta A, Atta M, Pranto AH, Gomes B, Lubaba A, Mohaimeen T, Abir SN, Saleem Khan M. Epstein-Barr virus (EBV) infection and associated post transplantation lymphoproliferative disease (PTLD) in hematopoietic stem cell transplantation (HSCT): a prevalence based systematic review and meta-analysis on global epidemiology. Expert Rev Anticancer Ther. 2026 Jan;26(1):105-117. doi: 10.1080/14737140.2025.2557615. Epub 2025 Sep 8
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Article