异基因造血干细胞移植后巨细胞病毒感染和抢先治疗临床研究

发布时间：2018-11-14 07:33

【摘要】：目的:探讨异基因造血干细胞移植(allogenic hematopoietic stem cell transplantation,allo-HSCT)后巨细胞病毒(CMV)感染的临床特点和抢先治疗的临床意义。方法:对本院血液科2010年3月至2015年3月134例alloHSCT患者巨细胞病毒感染情况进行了回顾性分析,对移植后CMV感染的累积发生率、发生中位时间、相关危险因素,抢先治疗有效率、转阴中位时间以及移植患者长期生存率进行了统计分析。结果:Allo-HSCT后74/134例发生CMV血症(55.2%),发生的中位时间为移植后34(14-283)d。单因素分析和多因素分析均显示,预处理方案中应用ATG和合并Ⅱ-Ⅳ度a GVHD为CMV血症的危险因素;85.1%(63/74)的患者经抗病毒抢先治疗后转为阴性,转阴中位时间为15(5-82)d,其中2例患者发生巨细胞病毒肺炎。未发生CMV血症组移植患者5年生存率为66.3%,CMV血症组移植患者5年生存率为49%,两组间差异有统计学意义(P=0.041)。结论:预处理过程中使用ATG及合并Ⅱ-Ⅳ度a GVHD有可能增加allo-HSCT后CMV感染的发生率,抢先治疗能有效阻止CMV血症患者发病。
[Abstract]:Objective: to investigate the clinical features of cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allogenic hematopoietic stem cell transplantation,allo-HSCT) and its clinical significance. Methods: a retrospective analysis of cytomegalovirus infection in 134 patients with alloHSCT from March 2010 to March 2015 was carried out. The cumulative incidence, median time, risk factors of CMV infection after transplantation were analyzed. The median time of negative conversion and long-term survival rate of transplant patients were statistically analyzed. Results: CMV occurred in 74 / 134 cases (55.2%) after Allo-HSCT, and the median time was 34 (14-283) days after transplantation. Univariate analysis and multivariate analysis showed that ATG and GVHD with degree 鈪，

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