Ringdén O
Department of Clinical Immunology, Karolinska Institute, Huddinge Hospital, Stockholm, Sweden.
Ann Hematol. 1992 Jun;64 Suppl:A143-7. doi: 10.1007/BF01715369.
Latent herpes viruses such as herpes simplex virus, cytomegalovirus (CMV), and varicella zoster virus are often reactivated after bone marrow transplantation, giving rise to infections. In contrast, Epstein-Barr virus infections rarely occur. Significant mortality is induced especially by pneumonitis, most often caused by CMV. Immunosuppression and pancytopenia caused by CMV increase the risk of bacterial infections and invasive fungal infections. Herpes viruses may increase the risk of acute and chronic graft-versus-host disease (GVHD). Thus, immunity to several herpes viruses was associated with an increased risk of acute GVHD. Seropositivity for CMV in recipient and donor increased the risk of chronic GVHD. Herpes viruses were also associated with a decreased risk of leukemic relapse. CMV infection, asymptomatic CMV infection, and seropositivity for several herpes viruses were associated with a reduced incidence of relapse in different reports. In spite of this possible antileukemic effect, leukemia-free survival was unaffected by herpes virus immunity in recipients or donors.
潜伏性疱疹病毒，如单纯疱疹病毒、巨细胞病毒（CMV）和水痘带状疱疹病毒，在骨髓移植后常被重新激活，引发感染。相比之下，爱泼斯坦-巴尔病毒感染很少发生。特别是由肺炎引起的严重死亡率，最常见的是由CMV引起的。CMV引起的免疫抑制和全血细胞减少会增加细菌感染和侵袭性真菌感染的风险。疱疹病毒可能会增加急性和慢性移植物抗宿主病（GVHD）的风险。因此，对几种疱疹病毒的免疫与急性GVHD风险增加有关。受体和供体中CMV的血清阳性增加了慢性GVHD的风险。疱疹病毒也与白血病复发风险降低有关。在不同的报告中，CMV感染、无症状CMV感染以及几种疱疹病毒的血清阳性与复发率降低有关。尽管有这种可能的抗白血病作用，但受体或供体的疱疹病毒免疫对无白血病生存率没有影响。
