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造血细胞移植和血液系统恶性肿瘤患者的病毒性肺炎

Viral Pneumonia in Patients with Hematopoietic Cell Transplantation and Hematologic Malignancies.

作者信息

Green Margaret L

机构信息

University of Washington, 1959 NE Pacific Street, Box 359930, Seattle, WA 98195, USA; Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA.

出版信息

Clin Chest Med. 2017 Jun;38(2):295-305. doi: 10.1016/j.ccm.2016.12.009.

Abstract

Viral pneumonia is a common complication for patients with hematologic malignancies and after hematopoietic cell transplantation causing significant morbidity, and often mortality. Infections are predominantly caused by herpes viruses, either by reactivation of latent infection, or less commonly primary infection, or community respiratory viruses. High-resolution CT scan is useful for diagnosis but is nonspecific; generally, bronchoalveolar lavage is required. Prevention strategies are not pathogen-specific but include vaccination, chemoprophylaxis, preemptive treatment, and effective infection-prevention strategies during community outbreaks. Directed antiviral treatment is available for some pathogens. Toxicities and viral resistance are perennial challenges.

摘要

病毒性肺炎是血液系统恶性肿瘤患者及造血干细胞移植后常见的并发症,可导致严重发病,甚至常常导致死亡。感染主要由疱疹病毒引起,可因潜伏感染的重新激活,或较少见的原发性感染,或社区呼吸道病毒感染所致。高分辨率CT扫描有助于诊断,但缺乏特异性;一般需要进行支气管肺泡灌洗。预防策略并非针对特定病原体,而是包括疫苗接种、化学预防、抢先治疗以及社区疫情期间有效的感染预防策略。针对某些病原体有直接抗病毒治疗方法。毒性和病毒耐药性一直是挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de36/7115723/3d9accb0638c/gr1_lrg.jpg

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