Boström L, Ringdén O, Sundberg B, Ljungman P, Linde A, Nilsson B
Department of Clinical Immunology, Karolinska Institute, Huddinge Hospital, Sweden.
Bone Marrow Transplant. 1989 Sep;4(5):547-52.
The influence of pretransplant herpes virus antibodies in patients and donors in the subsequent development of chronic graft-versus-host disease (GVHD) was analysed in 150 consecutive HLA identical bone marrow recipients. The Cox regression bivariate analysis showed that (i) pretransplant seropositivity for cytomegalovirus (CMV) in the patients and the donors, (ii) donor seropositivity for herpes simplex virus and Epstein-Barr virus, (iii) high donor and patient age, (iv) a previous grade II-IV acute GVHD, (v) patients receiving unirradiated donor buffy coat cells post-transplant, (vi) overall CMV infection, (vii) high donor herpes virus load (positive serology for 3-4 herpes viruses versus 0-2), and (viii) high recipient herpes virus load prior to BMT were all associated with a high incidence of chronic GVHD. In Cox regression multivariate analysis, high pretransplant donor herpes virus load (p less than 0.001) and a previous grade II-IV acute GVHD (p = 0.02) were the strongest predictors of chronic GVHD. Thus, herpes virus immune cells in the donated marrow may play a role in the pathophysiology of chronic GVHD.
对150例连续的HLA配型相同的骨髓移植受者，分析了患者和供者移植前疱疹病毒抗体对随后慢性移植物抗宿主病（GVHD）发生的影响。Cox回归双变量分析显示：（i）患者和供者移植前巨细胞病毒（CMV）血清学阳性；（ii）供者单纯疱疹病毒和EB病毒血清学阳性；（iii）供者和患者年龄较大；（iv）既往有II-IV级急性GVHD；（v）移植后接受未照射的供者富含白细胞的血浆；（vi）总体CMV感染；（vii）供者疱疹病毒载量高（3-4种疱疹病毒血清学阳性与0-2种相比）；（viii）骨髓移植前受者疱疹病毒载量高，均与慢性GVHD的高发生率相关。在Cox回归多变量分析中，移植前供者疱疹病毒载量高（p<0.001）和既往有II-IV级急性GVHD（p=0.02）是慢性GVHD最强的预测因素。因此，供体骨髓中的疱疹病毒免疫细胞可能在慢性GVHD的病理生理过程中起作用。
