Miyashita Naohiro, Endo Tomoyuki, Onozawa Masahiro, Hashimoto Daigo, Kondo Takeshi, Fujimoto Katsuya, Kahata Kaoru, Sugita Junichi, Goto Hideki, Matsukawa Toshihiro, Hashino Satoshi, Teshima Takanori
Department of Hematology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
Health Care Center, Hokkaido University, Hokkaido, Japan.
Transpl Infect Dis. 2017 Jun;19(3). doi: 10.1111/tid.12682. Epub 2017 Apr 12.
Human herpesvirus 6 (HHV-6) encephalitis/myelitis is now a well-known complication after allogeneic stem cell transplantation (allo-HSCT), particularly after cord blood transplantation (CBT). In this study, we evaluated the risk factors of HHV-6 encephalitis/myelitis.
We evaluated 253 patients who received allo-HSCT from 2007 to 2015 at our institute. HHV-6 encephalitis/myelitis was defined as HHV-6 DNA detection in the cerebrospinal fluid or peripheral blood by polymerase chain reaction in the presence of typical manifestations without other concurrent condition that led to the manifestations.
HHV-6 encephalitis/myelitis occurred in 11 patients (4.5%) (9 encephalitis, 3.7%; 2 myelitis, 0.8%). Multivariate analysis showed that CBT, mycophenolate mofetil (MMF) for graft-versus-host disease prophylaxis, history of allogeneic hematopoietic stem cell transplantation (allo-HSCT), and engraftment syndrome (ES) were significantly associated with incidence of HHV-6 encephalitis/myelitis (P=.025, P=.017, P=.017, and P=.014, respectively).
Although it has been shown that CBT, ES, and history of allo-HSCT are risk factors for HHV-6 encephalitis/myelitis, our study demonstrated MMF is also a risk factor for the disease.
人疱疹病毒6型（HHV-6）脑炎/脊髓炎现已成为异基因造血干细胞移植（allo-HSCT），尤其是脐带血移植（CBT）后一种广为人知的并发症。在本研究中，我们评估了HHV-6脑炎/脊髓炎的危险因素。
我们评估了2007年至2015年在我院接受allo-HSCT的253例患者。HHV-6脑炎/脊髓炎定义为在存在典型表现且无其他导致这些表现的并发情况时，通过聚合酶链反应在脑脊液或外周血中检测到HHV-6 DNA。
11例患者（4.5%）发生了HHV-6脑炎/脊髓炎（9例脑炎，3.7%；2例脊髓炎，0.8%）。多因素分析显示，CBT、用于预防移植物抗宿主病的霉酚酸酯（MMF）、异基因造血干细胞移植（allo-HSCT）史和植入综合征（ES）与HHV-6脑炎/脊髓炎的发生率显著相关（P分别为0.025、0.017、0.017和0.014）。
尽管已有研究表明CBT、ES和allo-HSCT史是HHV-6脑炎/脊髓炎的危险因素，但我们的研究表明MMF也是该疾病的危险因素。
