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
Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.
Zhonghua Xue Ye Xue Za Zhi. 2013 Aug;34(8):651-4. doi: 10.3760/cma.j.issn.0253-2727.2013.08.002.
To analyze the prevalence of Epstein Barr Virus (EBV) in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT).
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.
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.
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.
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。
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。
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。
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。