Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center , Petah-Tikva , Israel.
Sackler School of Medicine, Tel Aviv University , Tel Aviv , Israel.
Leuk Lymphoma. 2019 Sep;60(9):2230-2236. doi: 10.1080/10428194.2019.1576869. Epub 2019 Feb 18.
Data regarding presentation and management of human herpes virus 6 (HHV-6) reactivation among autologous hematopoietic cell transplantation (HCT) recipients are limited. We retrospectively reviewed medical charts of all autologous HCT patients tested for HHV-6 reactivation due to suspected clinical presentation between 1/2012 and 8/2017. Among 328 autologous HCT recipients, 44 patients were tested for HHV-6 reactivation. Thirty patients tested positive; 29 (97%) had sustained fever, six (20%) had rash and four (13%) had pneumonia. Median C-reactive protein was significantly lower in HHV-6 positive patients compared to negative patients (3.6 (range, 0.4-11) vs. 9.6 (range, 3.2-30) mg/dL, respectively, = .004). Ganciclovir formulations were administrated in 29 (97%) patients with median time to fever resolution of one (range, 1-2) day. HHV-6 should be considered as an important cause of post engraftment fever in autologous HCT. Larger studies are warranted to evaluate incidence of HHV-6 reactivation and optimal treatment regimen.
有关自身造血细胞移植（HCT）受者人类疱疹病毒 6（HHV-6）再激活的表现和治疗的数据有限。我们回顾性分析了 2012 年 1 月至 2017 年 8 月间因疑似临床表现而接受 HHV-6 再激活检测的所有自身 HCT 患者的病历。在 328 例自身 HCT 受者中，有 44 例接受了 HHV-6 再激活检测。30 例检测呈阳性；29 例（97%）有持续发热，6 例（20%）有皮疹，4 例（13%）有肺炎。与阴性患者相比，HHV-6 阳性患者的 C 反应蛋白中位数明显较低（分别为 3.6（范围，0.4-11）与 9.6（范围，3.2-30）mg/dL，= 0.004）。29 例（97%）患者给予更昔洛韦制剂治疗，发热缓解中位时间为 1 天（范围，1-2 天）。HHV-6 应被视为自身 HCT 后移植物期发热的重要原因。需要进行更大规模的研究来评估 HHV-6 再激活的发生率和最佳治疗方案。
