Cupit-Link Margaret C, Nageswara Rao Amulya, Warad Deepti M, Rodriguez Vilmarie, Khan Shakila
Mayo Medical School.
Division of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, MN.
J Pediatr Hematol Oncol. 2018 Nov;40(8):e473-e478. doi: 10.1097/MPH.0000000000001138.
The risk of viral infections and reactivation occurring in the setting of pediatric allogeneic hematopoietic stem cell transplantation is a concern in the pediatric patient, especially with the use of Alemtuzumab (Campath) as a conditioning agent. The purpose of this study was to determine the incidence of Epstein-Barr virus posttransplant lymphoproliferative disorder (EBV-PTLD), cytomegalovirus (CMV), and adenovirus among pediatric recipients of alemtuzumab at our institution. We found that EBV-PTLD occurred in 2.1% of transplants (1 matched unrelated donor [MUD] recipient), CMV reactivation occurred in 12.5% of transplants (4 MUD and 2 matched related donor [MRD] recipients) with disseminated CMV in 2.1% of cases (1 MRD recipient), and adenovirus infection occurred in 8.3% of the total transplants (2 MUD and 2 MRD recipients). Alemtuzumab continues to be used as a method of graft-versus-host disease and graft failure prevention among pediatric recipients of hematopoietic stem cell transplantation and seems to be safer than previously reported. At our institution, alemtuzumab has not increased the risk for EBV-PTLD, CMV infection, or adenovirus.
在儿科异基因造血干细胞移植中发生病毒感染和再激活的风险是儿科患者所关注的问题，尤其是在使用阿仑单抗（Campath）作为预处理药物时。本研究的目的是确定在我们机构接受阿仑单抗治疗的儿科受者中，移植后淋巴细胞增生性疾病（EBV-PTLD）、巨细胞病毒（CMV）和腺病毒的发生率。我们发现，EBV-PTLD在2.1%的移植中发生（1例匹配无关供体[MUD]受者），CMV再激活在12.5%的移植中发生（4例MUD和2例匹配相关供体[MRD]受者），其中2.1%的病例（1例MRD受者）出现播散性CMV，腺病毒感染在8.3%的总移植中发生（2例MUD和2例MRD受者）。阿仑单抗继续被用作预防造血干细胞移植儿科受者移植物抗宿主病和移植物失败的方法，并且似乎比先前报道的更安全。在我们机构，阿仑单抗并未增加EBV-PTLD、CMV感染或腺病毒的风险。
