Michálek J, Horváth R, Benedík J, Hrstková H
Department of Pediatric Hemato-Oncology, University Hospital Brno, Czech Republic.
Pediatr Hematol Oncol. 1999 Sep-Oct;16(5):423-30. doi: 10.1080/088800199276976.
Pediatric cancer patients treated with multimodal therapy are at a great risk of opportunistic infections or reactivation of latent infections. Human herpesvirus-6 (HHV-6) can serve as an example of such infection, with high seroprevalence in population. In 66 children with cancer and in 45 healthy controls, age matched, the presence of DNA HHV-6 was examined in peripheral blood by the polymerase chain reaction method. HHV-6 serology was also performed. No difference has been found between patients at the time of cancer diagnosis and the group of healthy children in the presence of DNA HHV-6 in blood, 17.4 and 15.6%, respectively. During cytotoxic chemotherapy the presence of HHV-6 in peripheral blood raised to 37.1% in patients with fever. Other parameters and symptoms such as febrile neutropenia, lymphopenia, exanthem, hepatopathy, lymphadenopathy, enteritis, bone marrow aplasia, pneumonitis, and encephalitis were examined in both the HHV-6 positive and HHV-6 negative groups of pediatric cancer patients. Statistically significant differences (p < .05) were found in case of lymphopenia, exanthem, and hepatopathy. In 4 out of 66 patients (6.1%) severe HHV-6 infection has been found: in 3 patients during cytotoxic chemotherapy and in 1 at the time of cancer diagnosis. Reactivation of HHV-6 infection in pediatric cancer patients under treatment with cytotoxic chemotherapy is frequent and can lead to severe complications as described in patients after bone marrow or organ transplantation.
接受多模式治疗的儿科癌症患者面临机会性感染或潜伏感染重新激活的巨大风险。人类疱疹病毒6型(HHV - 6)就是这类感染的一个例子,在人群中的血清阳性率很高。对66名癌症患儿和45名年龄匹配的健康对照者,采用聚合酶链反应法检测外周血中HHV - 6 DNA的存在情况。同时也进行了HHV - 6血清学检测。在癌症诊断时,患者血液中HHV - 6 DNA的存在率分别为17.4%,与健康儿童组相比无差异,健康儿童组为15.6%。在细胞毒性化疗期间,发热患者外周血中HHV - 6的存在率升至37.1%。对HHV - 6阳性和HHV - 6阴性的儿科癌症患者组还检查了其他参数和症状,如发热性中性粒细胞减少、淋巴细胞减少、皮疹、肝病、淋巴结病、肠炎、骨髓再生障碍、肺炎和脑炎。在淋巴细胞减少、皮疹和肝病方面发现了统计学上的显著差异(p < 0.05)。在66名患者中有4名(6.1%)发现了严重的HHV - 6感染:3名患者在细胞毒性化疗期间,1名在癌症诊断时。接受细胞毒性化疗的儿科癌症患者中HHV - 6感染的重新激活很常见,并且可能导致如骨髓或器官移植后患者中所描述的严重并发症。