干细胞移植后膦甲酸钠治疗耐更昔洛韦的巨细胞病毒视网膜炎：通过巨细胞病毒mRNA定量分析有效监测巨细胞病毒感染

Foscarnet therapy for ganciclovir-resistant cytomegalovirus retinitis after stem cell transplantation: effective monitoring of CMV infection by quantitative analysis of CMV mRNA.

作者信息

Ohta H, Matsuda Y, Tokimasa S, Sawada A, Kim J Y, Sashihara J, Amo K, Miyagawa H, Tanaka-Taya K, Yamamoto S, Tano Y, Aono T, Yamanishi K, Okada S, Hara J

机构信息

Department of Developmental Medicine (Pediatrics), Osaka University Graduate School of Medicine, Suita, Japan.

出版信息

Bone Marrow Transplant. 2001 Jun;27(11):1141-5. doi: 10.1038/sj.bmt.1703055.

DOI:10.1038/sj.bmt.1703055

PMID:11551024

Abstract

We report three pediatric patients with ganciclovir-resistant cytomegalovirus (CMV) retinitis who were successfully treated with foscarnet. The patients were recipients of hematopoietic stem cell transplantation (SCT) from HLA-mismatched donors. Because these patients had developed or experienced progressive CMV retinitis during ganciclovir therapy, they received foscarnet therapy at 60 mg/kg every 8 h. Their retinitis resolved promptly after initiating foscarnet therapy, suggesting foscarnet's effectiveness in treating ganciclovir-resistant CMV infection. The amount of CMV mRNA was quantitatively measured using an NASBA technique, which amplified the beta2.7 transcripts specific for CMV replication. This technique was useful for monitoring disease activity in a more rapid and sensitive manner than the PCR assay for CMV DNA.

摘要

我们报告了3例对更昔洛韦耐药的巨细胞病毒（CMV）视网膜炎儿科患者，他们接受膦甲酸钠治疗后获得成功。这些患者接受了来自HLA不匹配供者的造血干细胞移植（SCT）。由于这些患者在更昔洛韦治疗期间发生或经历了进行性CMV视网膜炎，因此他们接受了膦甲酸钠治疗，剂量为每8小时60mg/kg。在开始膦甲酸钠治疗后，他们的视网膜炎迅速消退，提示膦甲酸钠在治疗更昔洛韦耐药的CMV感染方面有效。使用NASBA技术对CMV mRNA的量进行定量测定，该技术可扩增CMV复制特异的β2.7转录本。与CMV DNA的PCR检测法相比，该技术在以更快速和敏感的方式监测疾病活动方面很有用。