Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Int J Mol Sci. 2019 May 30;20(11):2666. doi: 10.3390/ijms20112666.
Cytomegalovirus (CMV) infection after hematopoietic stem cell transplantation (HSCT) is one of the critical infectious complications related to host immune recovery. The spectrum of CMV infection is quite extensive, from asymptomatic CMV reactivation presenting mainly as CMV DNAemia to fatal CMV diseases involving gut, liver, lungs, or brain. In addition to organ involvement, CMV reactivation can exert indirect effects such as immunosuppression or graft failure that may result in the development of concurrent infectious complications. Currently, preemptive therapy, which is based on PCR-based monitoring of CMV from blood, is a mainstay enabling improvement in CMV-related outcomes. During the past decades, new antiviral drugs, clinical trials for prophylaxis in high-risk groups, and vaccines for preventing CMV infection have been introduced. In addition, data for immunologic monitoring and adoptive immunotherapy have also been accumulated. Here, we review the current status and recent updates in this field, with future perspectives including immunotherapy in HSCT recipients.
造血干细胞移植（HSCT）后巨细胞病毒（CMV）感染是与宿主免疫恢复相关的关键感染性并发症之一。CMV 感染的范围非常广泛，从主要表现为 CMV DNA 血症的无症状 CMV 再激活到涉及肠道、肝脏、肺部或大脑的致命 CMV 疾病。除了器官受累外，CMV 再激活还会产生免疫抑制或移植物衰竭等间接影响，从而导致并发感染性并发症的发生。目前，基于血液 CMV 的 PCR 监测的抢先治疗是改善 CMV 相关结局的主要方法。在过去几十年中，已经引入了新的抗病毒药物、高危人群预防的临床试验和预防 CMV 感染的疫苗。此外，还积累了免疫监测和过继免疫治疗的数据。在这里，我们回顾了该领域的现状和最新进展，包括 HSCT 受者的免疫治疗的未来展望。
Zotero 插件