Rieger C T, Rieger H, Kolb H J, Peterson L, Huppmann S, Fiegl M, Ostermann H
Department of Hematology/Oncology, University of Munich Campus Grosshadern, Munich, Germany.
Transpl Infect Dis. 2009 Jun;11(3):220-6. doi: 10.1111/j.1399-3062.2009.00379.x. Epub 2009 Mar 9.
Bacterial, viral, and fungal pathogens frequently cause severe, life-threatening infections in immunocompromised patients after allogeneic hematopoietic stem cell transplantation (SCT).
To compare the frequency of infections in patients with matched-related (Group A) or with human leukocyte antigen (HLA)-matched-unrelated donors (Group B).
Patients treated at our transplantation unit between April 2004 and April 2005 were enrolled into this analysis. Documentation comprised demographic data, conditioning treatment, stem cell source, clinical course, as well as microbiological and clinical data and mortality.
We analyzed 59 patients, 22 in Group A and 37 in Group B. Both groups were well balanced regarding demographic data. Diagnoses were acute myeloid leukemia (30 of 59 patients, 50.8%), multiple myeloma (15.2%), acute lymphoblastic leukemia (11.9%), and chronic myeloid leukemia (10.2%). Patients in Group A developed infections in 95.5% of the cases compared with 97.3% in patients in Group B. Most frequently detected pathogens were Staphylococcus species, human herpesvirus-6, and Epstein-Barr virus. Three proven fungal infections were detected in Group A compared with 9 proven fungal infections in Group B. Lung infiltrations were observed in equivalent incidence in both groups. Two years after transplantation, 55.9% of patients were alive (Group A: 68.2%; Group B: 48.6%, not significant).
Allogeneic SCT from HLA-matched-unrelated donors does not have a higher infection risk than patients transplanted from matched-related donors.
细菌、病毒和真菌病原体经常在异基因造血干细胞移植（SCT）后的免疫功能低下患者中引起严重的、危及生命的感染。
比较同胞相合供者（A组）和人类白细胞抗原（HLA）相合的无关供者（B组）患者的感染发生率。
纳入2004年4月至2005年4月在我们移植单元接受治疗的患者进行分析。记录内容包括人口统计学数据、预处理治疗、干细胞来源、临床病程以及微生物学和临床数据及死亡率。
我们分析了59例患者，A组22例，B组37例。两组在人口统计学数据方面均衡良好。诊断包括急性髓系白血病（59例患者中的30例，50.8%）、多发性骨髓瘤（15.2%）、急性淋巴细胞白血病（11.9%）和慢性髓系白血病（10.2%）。A组患者感染发生率为95.5%，B组为97.3%。最常检测到的病原体是葡萄球菌属、人疱疹病毒6型和EB病毒。A组检测到3例确诊真菌感染，B组为9例。两组肺浸润发生率相当。移植后两年，55.9%的患者存活（A组：68.2%；B组：48.6%，无显著差异）。
来自HLA相合无关供者的异基因SCT与来自同胞相合供者移植的患者相比，感染风险并不更高。
