Department of Haematology, Level II ICPMR, Westmead Hospital, Westmead, NSW 2145, Australia.
Biol Blood Marrow Transplant. 2011 Jan;17(1):147-53. doi: 10.1016/j.bbmt.2010.07.004. Epub 2010 Jul 15.
There are limited data on the impact of H1N109 infection in patients undergoing hematopoietic stem cell transplantation (HSCT). We reviewed individual medical records of patients who underwent HSCT or were on follow-up post-HSCT between May and September 2009. Thirteen patients with H1N109 infection were identified: 2 <100 days post-HSCT, 7 >100 days post-HSCT, and 4 just prior to HSCT. Five (38.7%) had lower respiratory tract involvement (LRTI), whereas the remainder had upper respiratory tract involvement (URTI). LRTI occurred in patients who were profoundly neutropenic post-HSCT or on potent immunosuppression for chronic graft-versus-host disease (cGVHD). At 100 days post-H1N109 infection, only 1 patient with LRTI survived, whereas all with URTI are alive. Four patients successfully treated for H1N109 infection prior to HSCT underwent the procedure after 4 to 6 weeks without any complications. Another 6 patients received oseltamivir prophylaxis during conditioning and none developed H1N109 infection. In conclusion, H1N109 infection was associated with LRTI in HSCT recipients who were profoundly neutropenic or immunosuppressed. Prior H1N109 infection did not affect the successful outcome of HSCT and oseltamivir prophylaxis in a small group of recipients resulted in no infection. Further studies are required.
关于接受造血干细胞移植（HSCT）的患者中 H1N109 感染的影响，数据有限。我们回顾了 2009 年 5 月至 9 月期间接受 HSCT 或 HSCT 后随访的患者的个人病历。共确定了 13 例 H1N109 感染患者：2 例患者在 HSCT 后<100 天，7 例患者在 HSCT 后>100 天，4 例患者在 HSCT 前。其中 5 例（38.7%）有下呼吸道受累（LRTI），其余有上呼吸道受累（URTI）。LRTI 发生在 HSCT 后严重中性粒细胞减少或慢性移植物抗宿主病（cGVHD）强效免疫抑制的患者中。在感染 H1N109 后 100 天，仅 1 例 LRTI 患者存活，而所有 URTI 患者均存活。4 例在 HSCT 前成功治疗 H1N109 感染的患者在 4 至 6 周后无并发症地进行了该手术。另外 6 例患者在预处理期间接受了奥司他韦预防治疗，均未发生 H1N109 感染。总之，H1N109 感染与严重中性粒细胞减少或免疫抑制的 HSCT 受者的 LRTI 相关。先前的 H1N109 感染并未影响 HSCT 的成功结果，而少数接受者的奥司他韦预防治疗并未导致感染。需要进一步研究。
