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[异基因造血干细胞移植患者中EB病毒感染的患病率]

[Prevalence of EBV infection in patients with allogeneic hematopoietic stem cell transplantation].

作者信息

Han Ting-ting, Xu Lan-ping, Liu Dai-hong, Liu Kai-yan, Zhang Xiao-hui, Chen Huan, Chen Yu-hong, Han Wei, Wang Feng-rong, Wang Yu, Wang Jing-zhi, Huang Xiao-jun

机构信息

Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2013 Aug;34(8):651-4. doi: 10.3760/cma.j.issn.0253-2727.2013.08.002.

Abstract

OBJECTIVE

To analyze the prevalence of Epstein Barr Virus (EBV) in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODS

We retrospectively analyzed the clinical characteristics of 720 patients received allo-HSCT from January 2010 through December 2011 in the Stem Cell Transplant Center of People's Hospital.

RESULTS

Of 720 patients (469 male presented and 251 females), with a median age of 30 years (range, 2 to 67 years) old, 66 patients were presented with EBV reactivation. The cumulative incidence of EBV reactivation was (9.3±1.1)%, with a median days of 54.5 (range, 18 to 253 days). During one- year post-transplantation, the cumulative incidences of EBV reactivation in sibling allo-HSCT, haploidentical HSCT and unrelated donor HSCT were (1.3±0.7)%, (13.7±1.7)%, and (9.1±4.4)%, respectively. In patients with haplo-identical HSCT, the cumulative incidences of EBV viremia, probable EBV disease, and post-transplant lymphoproliferative disease (PTLD) were (5.8±1.1)%, (5.7±1.1)%, and (2.3±0.7)%. The mortality was (33.9±5.9)% in all patients with EBV infection: (63.6±15.8)% in PTLD, (42.3±9.9)% in probable EBV disease, (13.8±6.5)% in EBV viremia. By univariate and multivariate analysis, the use of ATG was an independent risk factor for EBV infection.

CONCLUSION

EBV reactivation is a common complication in patients with allo- HSCT, especially high mortality in PTLD and probable EBV disease. The use of ATG was an independent risk factor for EBV infection.

摘要

目的

分析异基因造血干细胞移植(allo-HSCT)患者中爱泼斯坦-巴尔病毒(EBV)的感染率。

方法

回顾性分析2010年1月至2011年12月在人民医院干细胞移植中心接受allo-HSCT的720例患者的临床特征。

结果

720例患者(男性469例,女性251例),中位年龄30岁(范围2至67岁),66例出现EBV再激活。EBV再激活的累积发生率为(9.3±1.1)%,中位天数为54.5天(范围18至253天)。移植后1年内,同胞全相合allo-HSCT、单倍体相合HSCT和无关供者HSCT中EBV再激活的累积发生率分别为(1.3±0.7)%、(13.7±1.7)%和(9.1±4.4)%。在单倍体相合HSCT患者中,EBV病毒血症、可能的EBV相关疾病和移植后淋巴细胞增殖性疾病(PTLD)的累积发生率分别为(5.8±1.1)%、(5.7±1.1)%和(2.3±0.7)%。所有EBV感染患者的死亡率为(33.9±5.9)%:PTLD患者为(63.6±15.8)%,可能的EBV相关疾病患者为(42.3±9.9)%,EBV病毒血症患者为(13.8±6.5)%。单因素和多因素分析显示,使用抗胸腺细胞球蛋白(ATG)是EBV感染的独立危险因素。

结论

EBV再激活是allo-HSCT患者常见的并发症,尤其是PTLD和可能的EBV相关疾病死亡率高。使用ATG是EBV感染的独立危险因素。

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