Yue Caifeng, Kang ZhiJie, Ai Kexin, Xu Duorong, Wu Jim, Pan Yujia, Yan JinSong, Liu Min, Liu Quentin
Department of Hematology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Oncotarget. 2016 Aug 16;7(33):53930-53940. doi: 10.18632/oncotarget.10182.
Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective therapy for patients with hematologic malignancies. Severe pneumonia is associated with high mortality rate in HSCT recipients. Viral co-infection indicates a poor prognosis of HSCT recipients. In this study, a total of 68 allogeneic HSCT recipients were included. Cytomegalovirus (CMV) and Respiratory syncytial virus (RSV) infection was assessed by testing peripheral blood and oropharynx swabs, respectively, collected in the first 180 days after transplantation. We analysed the correlation of CMV and RSV co-infection with severe pneumonia and mortality. The incidence of CMV and RSV co-infection was 26.5% (18/68). Severe pneumonia was diagnosed in 61% (11/18) cases with co-infection compared to only 10% (5/50) cases with mono-infection or no infection. The analysis of potential risk factors for severe pneumonia showed that CMV and RSV co-infection was significantly associated with severe pneumonia (p < 0.001). The 5 patients who died of severe pneumonia were all co-infected with CMV and RSV. In conclusion, CMV and RSV co-infection appears to be an important factor and facilitates the development of severe pneumonia in allogeneic HSCT patients with hematologic malignancies.
异基因造血干细胞移植（HSCT）是治疗血液系统恶性肿瘤患者的有效方法。严重肺炎在HSCT受者中与高死亡率相关。病毒合并感染提示HSCT受者预后不良。本研究共纳入68例异基因HSCT受者。分别通过检测移植后180天内采集的外周血和口咽拭子来评估巨细胞病毒（CMV）和呼吸道合胞病毒（RSV）感染情况。我们分析了CMV和RSV合并感染与严重肺炎及死亡率的相关性。CMV和RSV合并感染的发生率为26.5%（18/68）。合并感染的病例中有61%（11/18）被诊断为严重肺炎，而单一感染或未感染的病例中只有10%（5/50）被诊断为严重肺炎。对严重肺炎潜在危险因素的分析表明，CMV和RSV合并感染与严重肺炎显著相关（p<0.001）。5例死于严重肺炎的患者均为CMV和RSV合并感染。总之，CMV和RSV合并感染似乎是异基因HSCT血液系统恶性肿瘤患者发生严重肺炎的一个重要因素，并促进了严重肺炎的发展。
