Xie Weimin, Zhang Xi, Peng Guihua, Yi Bin, Liu Wen'en, Zhong Baiyun, Jian Zijuan, Fan Yunrong
Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2010 Nov;35(11):1162-6. doi: 10.3969/j.issn.1672-7347.2010.11.008.
To explore the correlation between peripheral blood cytomegalovirus (CMV) DNA level and cyclosporine A (CsA) plasma concentration among allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients who received immunosuppressant treatment, and to evaluate the potential clinical value.
A total of 32 allo-HSCT patients were enrolled and their data were analyzed retrospectively. Ganciclovir was used to prevent CMV infection before the transplantation. Routine fluorescence PCR was admitted to test the blood CMV DNA level. The patients were divided into 2 groups: a CMV DNA positive group and a CMV DNA negative group. Enzyme multiplied immunoassay technique was adopted regularly to monitor the blood CsA concentration. The correlation between CMV DNA level and CsA concentration was analyzed.
The CMV infection rate in patients who received allo-HSCT was 53.13%. The blood CsA concentration in the CMV DNA positive group was significantly higher than that in the CMV DNA negative group (P<0.05). Through the ROC curve, the area under the curve on Day 1, 7, and 14 had statistical significance compared with 0.5, and the corresponding blood CsA concentration was 203.15, 215.55, and 302.65 ng/mL, respectively.
Immunosuppressive drug concentration can affect the dynamic changes of CMV DNA. High blood CsA concentration may be one of the reasons for CMV infection. Monitoring the blood CsA concentration may provide guidance for clinical treatment.
探讨接受免疫抑制剂治疗的异基因造血干细胞移植（allo-HSCT）受者外周血巨细胞病毒（CMV）DNA水平与环孢素A（CsA）血药浓度之间的相关性，并评估其潜在临床价值。
共纳入32例allo-HSCT患者，对其数据进行回顾性分析。移植前使用更昔洛韦预防CMV感染。采用常规荧光定量PCR检测血液CMV DNA水平。将患者分为2组：CMV DNA阳性组和CMV DNA阴性组。定期采用酶放大免疫分析技术监测血液CsA浓度。分析CMV DNA水平与CsA浓度之间的相关性。
allo-HSCT患者的CMV感染率为53.13%。CMV DNA阳性组的血CsA浓度显著高于CMV DNA阴性组（P<0.05）。通过ROC曲线分析，第1天、第7天和第14天的曲线下面积与0.5相比具有统计学意义，对应的血CsA浓度分别为203.15、215.55和302.65 ng/mL。
免疫抑制药物浓度可影响CMV DNA的动态变化。高血CsA浓度可能是CMV感染的原因之一。监测血CsA浓度可为临床治疗提供指导。
