Kelsey S M, Newland A C
Department of Haematology, London Hospital, Whitechapel, UK.
Bone Marrow Transplant. 1989 Sep;4(5):543-6.
Cytomegalovirus (CMV) seropositivity in recipients of an allogeneic bone marrow transplant (BMT) is a major risk factor for development of post-transplant CMV infection. CMV serology was assessed in 98 patients during intensive chemotherapy for haematological malignancy prior to allogeneic BMT. Thirty-seven patients eventually received a BMT; the remaining 61 patients were treated with chemotherapy alone. The proportion of seropositive patients in the BMT group increased from 36% to 48% between presentation and transplantation. This represents an increase in recipient seropositivity of 33% as a direct result of pre-transplant therapy. Mean time to seroconversion was 186 days. Seropositivity in patients receiving chemotherapy only increased from 43% to 56% during treatment and follow-up. The most likely source of the CMV acquired by these patients is CMV-infected blood products. We suggest that, wherever possible, CMV-negative blood products should be used exclusively from presentation to support all patients receiving chemotherapy in whom BMT is a therapeutic option.
在异基因骨髓移植（BMT）受者中，巨细胞病毒（CMV）血清学阳性是移植后发生CMV感染的主要危险因素。在98例接受异基因BMT的血液系统恶性肿瘤患者强化化疗期间，对其CMV血清学进行了评估。37例患者最终接受了BMT；其余61例患者仅接受化疗。BMT组血清学阳性患者的比例在就诊时到移植期间从36%增加到48%。这表明作为移植前治疗的直接结果，受者血清学阳性率增加了33%。血清转化的平均时间为186天。仅接受化疗的患者在治疗和随访期间血清学阳性率从43%增加到56%。这些患者获得CMV的最可能来源是CMV感染的血液制品。我们建议，只要有可能，应从就诊时起专门使用CMV阴性血液制品，以支持所有接受化疗且BMT是一种治疗选择的患者。
