Ksouri H, Lakhal A, Ben Amor R, Torjman L, Achour W, Ben Othmen T, Ladeb S, Abdelkefi A, Slim A, Abdeladhim A, Ben Hassen A
Service des laboratoires du Centre national de greffe de moelle osseuse, Tunis, Tunisie.
Bull Soc Pathol Exot. 2006 Jul;99(3):155-9.
In this article a Cytomegalovirus (CMV) antigenemia and semiquantitative PCR retrospective evaluation of 26 bone marrow allo-grafted patients for different haematological disease is reported. Eighteen patients had a CMV reactivation despite a prophylactic treatment, seven of those patients had both positive antigenemia pp65 and positive semi-quantitative CMV PCR. During CMV reactivation, 3 patients developed a CMV disease despite a pre-emptive therapy. The follow up of the antigenemia was performed since D21 until D100 post transplantation, the antigenemia positivity occurred at D53 and was preceded about 7 days by CMV PCR positivity The CMV disease wasn't associated with a high viral load. All patients that had CMV reactivation had a positive CMV serology before the graft, whereas only 37.5% of the patients who did not reactivate had a positive CMV serology. Respectively half patients who reactivated and only 12.5% of those who didn't had a Graft versus host disease (GVHD), witch preceded the reactivation about 21 days in six of the formers. Clinical and biological signs presented by our patients in this cases report, seems to be associated more with the GVHD than with CMV reactivation.
本文报道了对26例不同血液系统疾病的骨髓移植患者进行巨细胞病毒(CMV)抗原血症和半定量PCR的回顾性评估。尽管进行了预防性治疗,仍有18例患者发生CMV再激活,其中7例患者抗原血症pp65阳性且半定量CMV PCR阳性。在CMV再激活期间,3例患者尽管接受了抢先治疗仍发生了CMV疾病。自移植后第21天至第100天对抗原血症进行随访,抗原血症阳性出现在第53天,在其前约7天CMV PCR呈阳性。CMV疾病与高病毒载量无关。所有发生CMV再激活的患者在移植前CMV血清学均为阳性,而未再激活的患者中只有37.5%的CMV血清学呈阳性。发生再激活的患者中有一半以及未发生再激活的患者中只有12.5%发生了移植物抗宿主病(GVHD),其中6例前者的GVHD在再激活前约21天出现。在本病例报告中,我们的患者所呈现的临床和生物学体征似乎更多与GVHD相关,而非与CMV再激活相关。