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采用多重聚合酶链反应检测50岁及以上异基因造血细胞移植受者呼吸道病毒感染的发生率及预测因素,包括老年评估。

Incidence and predictors of respiratory viral infections by multiplex PCR in allogeneic hematopoietic cell transplant recipients 50 years and older including geriatric assessment.

作者信息

D'Angelo Christopher R, Kocherginsky Masha, Pisano Jennifer, Bishop Michael R, Godley Lucy A, Kline Justin, Larson Richard A, Liu Hongtao, Odenike Olutoyosi, Stock Wendy, Artz Andrew S

机构信息

a Department of Medicine , University of Chicago ;

b Department of Public Health Sciences , University of Chicago , IL, USA.

出版信息

Leuk Lymphoma. 2016 Aug;57(8):1807-13. doi: 10.3109/10428194.2015.1113279. Epub 2015 Dec 24.

Abstract

Community respiratory viruses (CRV) are important agents of morbidity and mortality within the allogeneic hematopoietic stem cell transplant (HCT) population. Few proven methods to prevent CRV infections exist. No studies have specifically investigated their impact on older patients. We reviewed patients 50 years and older undergoing HCT between 2009-2013 to determine the incidence of CRV infection using multiplex PCR and risk factors for infection including geriatric assessment (GA). Thirty-two first episode CRV infections occurred in 118 patients for a 1-year cumulative incidence of 27.2% (CI: 19.4-35.6%). Hospitalization and mortality were restricted to those who developed lower respiratory tract infections (LRTI) (n = 22, 69%). CRV infection contributed to 8 deaths (36% of LRTIs) and 7 of these patients were taking steroids for GvHD at the time of infection. Health impairments by GA did not translate into increased risk for CRV infection. Steroid use at time of LRTI was associated with high mortality.

摘要

社区呼吸道病毒(CRV)是异基因造血干细胞移植(HCT)人群发病和死亡的重要病原体。目前几乎没有经证实的预防CRV感染的方法。尚无研究专门调查其对老年患者的影响。我们回顾了2009年至2013年间接受HCT的50岁及以上患者,以使用多重PCR确定CRV感染的发生率以及包括老年评估(GA)在内的感染危险因素。118例患者中发生了32例首次CRV感染,1年累积发生率为27.2%(CI:19.4 - 35.6%)。住院和死亡仅限于发生下呼吸道感染(LRTI)的患者(n = 22,69%)。CRV感染导致8例死亡(占LRTI的36%),其中7例患者在感染时正在接受用于治疗移植物抗宿主病(GvHD)的类固醇治疗。GA评估的健康损害并未转化为CRV感染风险的增加。LRTI时使用类固醇与高死亡率相关。

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