Jacobsen N, Lönnqvist B, Ringdén O, Rajantie J, Siimes M A, Volin L, Ruutu T, Nikoskelainen J, Toivanen A, Ryder L
Eur J Haematol. 1987 Apr;38(4):350-5. doi: 10.1111/j.1600-0609.1987.tb00010.x.
To elucidate whether a relationship existed between bone marrow donor cytomegalovirus (CMV) immune status and the probability of staying in remission after transplantation, a retrospective multicentre analysis was performed in 69 patients who received allogeneic bone marrow transplantation during relapse or second remission of AML, or second remission of ALL. None of 12 AML patients with CMV seropositive donors had posttransplant relapse, in contrast to 7 of 10 AML patients with seronegative donors. Kaplan-Meier estimates of the 2-yr probability of staying in remission for the two groups were 100% and 0%, respectively (p less than 0.0005). This effect was independent of disease stage, donor and recipient age, recipient pretransplant CMV immune status and the occurrence of posttransplant CMV infection in recipients, and was not mediated through an increased occurrence of overt graft-versus-host disease (GvHD) in recipients with CMV seropositive donors. The increased probability of staying in remission was associated with an increased probability of 3-yr disease-free survival (p less than 0.01). No similar effect was observed in patients with ALL. This study may suggest an allograft-versus-leukaemia effect in AML, associated with CMV seropositive donors, which seems separate from GvHD and independent of the occurrence of posttransplant CMV infection.
为了阐明骨髓供者巨细胞病毒（CMV）免疫状态与移植后缓解持续概率之间是否存在关联，对69例在急性髓系白血病（AML）复发或第二次缓解期，或急性淋巴细胞白血病（ALL）第二次缓解期接受异基因骨髓移植的患者进行了一项回顾性多中心分析。12例供者CMV血清学阳性的AML患者移植后均未复发，相比之下，10例供者血清学阴性的AML患者中有7例复发。两组患者2年缓解持续概率的Kaplan-Meier估计值分别为100%和0%（p<0.0005）。这一效应独立于疾病分期、供者和受者年龄、受者移植前CMV免疫状态以及受者移植后CMV感染的发生，并且不是通过供者CMV血清学阳性的受者中明显移植物抗宿主病（GvHD）发生率增加介导的。缓解持续概率增加与3年无病生存率增加相关（p<0.01）。在ALL患者中未观察到类似效应。本研究可能提示在AML中存在一种与供者CMV血清学阳性相关的移植物抗白血病效应，这似乎与GvHD无关且独立于移植后CMV感染的发生。
