Ruiz-Argüelles Guillermo J, Rangel J David Gómez, Ponce-de-León Samuel, González-Déctor Laura, Reyes-Núñez Virginia, Garcés-Eisele Javier
Centro de Hematología y Medicina Interna de Puebla, Puebla, Mexico.
Am J Hematol. 2004 Apr;75(4):200-4. doi: 10.1002/ajh.20026.
The prevalence of cytomegalovirus (CMV) reactivation and disease after non-myeloablative stem cell transplantation is largely unknown. Using fludarabine combined with alemtuzumab or antithymocyte globulin in the conditioning regimen, some authors have found increased prevalences of CMV disease, whereas other authors using different schedules have observed decreased prevalences. In a group of 17 individuals allografted using the Mexican conditioning regimen, which employs fludarabine, cyclophosphamide, and busulfan, we assessed CMV reactivation, morbidity, and mortality. Before transplant, IgG anti-CMV antibodies were found in 11 patients and in 10 donors; in 8 cases, both donor and patient had IgG anti-CMV antibodies. In only one case (6%) was CMV mRNA identified 30 days after the allograft during grade IV acute graft-versus-host disease. CMV reactivation, disease, and mortality were very low using our non-myeloablative stem cell transplantation schedule, which has been shown to be useful for allografting with minimal toxicity and reduced costs.
非清髓性干细胞移植后巨细胞病毒（CMV）再激活及疾病的发生率很大程度上尚不清楚。在预处理方案中使用氟达拉滨联合阿仑单抗或抗胸腺细胞球蛋白，一些作者发现CMV疾病的发生率增加，而其他使用不同方案的作者则观察到发生率降低。在一组17例采用墨西哥预处理方案（使用氟达拉滨、环磷酰胺和白消安）进行同种异体移植的个体中，我们评估了CMV再激活、发病率和死亡率。移植前，11例患者和10例供者中发现了IgG抗CMV抗体；8例中，供者和患者均有IgG抗CMV抗体。仅1例（6%）在同种异体移植后30天，IV级急性移植物抗宿主病期间检测到CMV mRNA。使用我们的非清髓性干细胞移植方案，CMV再激活、疾病和死亡率非常低，该方案已被证明对同种异体移植有用，毒性最小且成本降低。
