Lindahl Jenny K, Woxenius Susanne, Brune Mats, Andersson Rune
Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden.
Scand J Infect Dis. 2010 Sep;42(9):691-8. doi: 10.3109/00365541003777114.
Cytomegalovirus (CMV) is an important factor for morbidity and long-term outcome after allogeneic haematopoetic stem cell transplantation (allo-SCT). Cases of proven and probable CMV infection and disease among 97 allo-SCT recipients in Gothenburg, Sweden, 1997-2001, were analysed. CMV DNAemia was detected in 60 patients at a median of 30 days after SCT. Four patients (4%) had CMV disease; 2 had proven and 2 had probable CMV disease. Of these 4 patients, 1 died of CMV disease. In 1 additional patient, CMV was considered to have contributed to the patient's death. Fifty patients (51%) were treated in a total of 93 treatment episodes. The overall 1-y survival was 75% and the 5-y survival 55%. Patients with diagnosed CMV DNAemia had improved survival. No significant differences in survival rates were seen between the donor/recipient serological groups. An increased risk of CMV DNAemia was seen after SCT with a seronegative donor to a seropositive recipient. CMV disease with debut more than 110 days after transplantation was related to steroid treatment for graft-versus-host disease. The morbidity related to CMV disease following allo-SCT was low over the past 10 y, probably due to CMV surveillance and early treatment.
巨细胞病毒（CMV）是异基因造血干细胞移植（allo-SCT）后发病及长期预后的重要因素。对1997年至2001年瑞典哥德堡97例allo-SCT受者中确诊及疑似的CMV感染和疾病病例进行了分析。60例患者在SCT后中位30天检测到CMV血症。4例患者（4%）发生CMV疾病；2例确诊，2例疑似CMV疾病。这4例患者中，1例死于CMV疾病。另有1例患者，CMV被认为是导致患者死亡的原因之一。50例患者（51%）共接受了93次治疗。总体1年生存率为75%，5年生存率为55%。诊断为CMV血症的患者生存率有所提高。供体/受体血清学分组之间生存率无显著差异。SCT后，供体血清阴性受体血清阳性时，CMV血症风险增加。移植后110天以上首次发生的CMV疾病与移植物抗宿主病的类固醇治疗有关。过去10年中，allo-SCT后与CMV疾病相关的发病率较低，可能归因于CMV监测和早期治疗。
