Vandenbosch Kristel, Ovetchkine Philippe, Champagne Martin A, Haddad Elie, Alexandrov Lubomir, Duval Michel
Groupe de Recherche en Immunologie et Transplantation de Sang de Cordon, Service d'Hématologie-Oncologie, Centre de Cancérologie Charles-Bruneau, Montréal, Québec, Canada.
Biol Blood Marrow Transplant. 2008 Aug;14(8):867-71. doi: 10.1016/j.bbmt.2008.05.006.
Immune reconstitution may differ following cord blood transplantation (CBT) and bone marrow transplantation (BMT), and this may lead to a difference in varicella zoster virus (VZV) disease rates. One hundred fourteen VZV seropositive children received a CBT (37 patients), or a T-replete BMT (77 patients) at our institution. Patients did not received specific VZV disease prophylaxis. VZV disease was diagnosed by immunofluorescence or culture in 41 (36%) patients. In multivariate analysis, VZV disease was more frequent in older children (relative risk [RR] 1.11 per year; 95% confidence interval [CI], 1.04-1.18; P = .002), and after CBT (RR 2.27; 95% CI, 1.18-4.34; P = .013). The cumulative incidence of VZV disease at 3 years posttransplant was 46% following CBT. VZV disease incidence was 71% in CBT patients over 10 years old at transplant. Visceral dissemination occurred in 7 patients (6 CBT and 1 BMT) (P = .005). VZV disease is thus more frequent and more severe after CBT than after BMT.
脐带血移植（CBT）和骨髓移植（BMT）后的免疫重建可能有所不同，这可能导致水痘带状疱疹病毒（VZV）疾病发生率的差异。114名VZV血清阳性儿童在我们机构接受了CBT（37例患者）或T细胞充足的BMT（77例患者）。患者未接受特定的VZV疾病预防措施。41名（36%）患者通过免疫荧光或培养诊断出VZV疾病。在多变量分析中，年龄较大的儿童VZV疾病更常见（相对风险[RR]为每年1.11；95%置信区间[CI]，1.04 - 1.18；P = 0.002），且在CBT后（RR 2.27；95% CI，1.18 - 4.34；P = 0.013）。移植后3年VZV疾病的累积发病率在CBT后为46%。移植时年龄超过10岁的CBT患者中VZV疾病发病率为71%。7名患者（6名CBT患者和1名BMT患者）发生了内脏播散（P = 0.005）。因此，CBT后VZV疾病比BMT后更频繁且更严重。
