Ljungman P, Niederwieser D, Pepe M S, Longton G, Storb R, Meyers J D
Fred Hutchinson Cancer Research Center, Seattle.
Bone Marrow Transplant. 1990 Nov;6(5):295-300.
Data from 137 patients who underwent allogeneic marrow transplantation for aplastic anemia and who had sufficient virologic and serologic surveillance data were reviewed for risk factors for cytomegalovirus (CMV) infection and associations between CMV infection and acute or chronic graft-versus-host disease (GVHD). Total CMV infection (i.e. excretion or seroconversion) occurred in 58% of the patients. Twelve patients (9%) developed CMV pneumonia. Among seropositive patients occurrence of acute GVHD was associated with increased risk of total CMV infection and CMV excretion, but not of seroconversion. Acute GVHD did not influence the likelihood of total CMV infection, excretion, or seroconversion in seronegative patients. Among seronegative patients marrow donor seropositivity, buffy coat infusions, and granulocyte transfusions were significant risk factors for total CMV infection and seroconversion, but not for CMV excretion. No influence of either total CMV infection or the patient's or donor's serologic status for CMV was found on the risk of developing chronic GVHD in this homogeneous group of patients who underwent allogeneic marrow transplantation for aplastic anemia.
对137例接受再生障碍性贫血同种异体骨髓移植且有足够病毒学和血清学监测数据的患者的数据进行回顾,以分析巨细胞病毒(CMV)感染的危险因素以及CMV感染与急性或慢性移植物抗宿主病(GVHD)之间的关联。58%的患者发生了CMV总感染(即排泄或血清转化)。12例患者(9%)发生了CMV肺炎。在血清反应阳性的患者中,急性GVHD的发生与CMV总感染和CMV排泄风险增加相关,但与血清转化无关。急性GVHD对血清反应阴性患者的CMV总感染、排泄或血清转化可能性无影响。在血清反应阴性的患者中,骨髓供体血清反应阳性、白细胞层输注和粒细胞输注是CMV总感染和血清转化的显著危险因素,但不是CMV排泄的危险因素。在这组接受再生障碍性贫血同种异体骨髓移植的同质患者中,未发现CMV总感染或患者或供体的CMV血清学状态对发生慢性GVHD的风险有影响。