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异基因干细胞移植后早期巨细胞病毒复制与淋巴瘤复发风险降低相关。

Early CMV-replication after allogeneic stem cell transplantation is associated with a reduced relapse risk in lymphoma.

作者信息

Koldehoff Michael, Ross Stefan R, Dührsen Ulrich, Beelen Dietrich W, Elmaagacli Ahmet H

机构信息

a Department of Bone Marrow Transplantation , West German Cancer Center, University Hospital Essen, University of Duisburg-Essen , Essen , Germany.

b Institute of Virology, University Hospital Essen, University of Duisburg-Essen , Essen , Germany.

出版信息

Leuk Lymphoma. 2017 Apr;58(4):822-833. doi: 10.1080/10428194.2016.1217524. Epub 2016 Aug 10.

Abstract

A preventive effect of early human cytomegalovirus (HCMV) replication was evaluated in 136 non-Hodgkin lymphoma (NHL) patients with mature B-cell NHLs (n = 94), and mature T- and NK-cell NHLs (n = 42) after allogeneic stem cell transplantation (alloSCT). Most study-patients (85%) had received at least 2 cycles of chemotherapy and 60% had also received an autograft prior to alloSCT. First detection of CMV-replication by HCMV antigenemia/viremia was found at a median of day +33 after alloSCT. The cumulative incidence of relapse at 5 years after alloSCT was 38% (95% confidence interval [95%CI]: 26-49) in 82 patients without compared to 22% (95%CI: 8-37) in 54 patients with HCMV antigenemia/viremia (p = .013). A decreased relapse risk of HCMV replication was confirmed by multivariate analysis for HCMV antigenemia/viremia (Hazard ratio [HR]: 0.29, 95%CI: 0.11-0.76, p < .014). This report demonstrated a possible improvement of relapse incidence after replicative HCMV infection in patients with NHL after alloSCT.

摘要

在136例接受异基因干细胞移植(alloSCT)的非霍奇金淋巴瘤(NHL)患者中,评估了早期人巨细胞病毒(HCMV)复制的预防作用,这些患者包括成熟B细胞NHL(n = 94)和成熟T细胞及NK细胞NHL(n = 42)。大多数研究患者(85%)在alloSCT前接受了至少2个周期的化疗,60%还接受了自体移植。通过HCMV抗原血症/病毒血症首次检测到CMV复制的时间中位数为alloSCT后第33天。在82例未出现HCMV抗原血症/病毒血症的患者中,alloSCT后5年的累积复发率为38%(95%置信区间[95%CI]:26 - 49),而在54例出现HCMV抗原血症/病毒血症的患者中为22%(95%CI:8 - 37)(p = 0.013)。多因素分析证实,HCMV抗原血症/病毒血症患者的复发风险降低(风险比[HR]:0.29,95%CI:0.11 - 0.76,p < 0.014)。本报告表明,alloSCT后NHL患者发生复制性HCMV感染后,复发率可能有所改善。

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