Yan Chen-Hua, Wang Yu, Mo Xiao-Dong, Sun Yu-Qian, Wang Feng-Rong, Fu Hai-Xia, Chen Yao, Han Ting-Ting, Kong Jun, Cheng Yi-Fei, Zhang Xiao-Hui, Xu Lan-Ping, Liu Kai-Yan, Huang Xiao-Jun
Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Xi Zhimen South Street No. 11, Beijing, 100044, China.
Collaborative Innovation Center of Hematology, Suzhou, China.
Bone Marrow Transplant. 2020 Jun;55(6):1147-1160. doi: 10.1038/s41409-020-0790-z. Epub 2020 Jan 28.
This study investigated the epidemiological characteristics of cytomegalovirus retinitis (CMVR) after haploidentical hematopoietic stem cell transplantation (HSCT). We studied a cohort of 1466 consecutive patients who had undergone haploidentical HSCT between 2013 and 2017. We documented 34 episodes of CMVR in 31 patients, with a median onset of 167 days after the transplant. The cumulative incidence of CMVR was 2.3% 1 year after the transplant. Multivariate analysis suggested that platelet engraft failure at 100 days, EBV DNAemia, refractory or recurrent CMV DNAemia, and acute graft-versus-host disease were related to the development of CMVR in patients with CMV DNAemia. Patients with ≥3 risk factors (high risk) had a higher 1-year incidence of CMVR than patients with ≤2 risk factors (low risk) (26.2% vs. 0.6%, P < 0.001). In patients with CMVR, visual acuity (VA) improved in 16 episodes, remained stable in 10 episodes, and worsened in 8 episodes. The variable related to the improvement of VA was VA ≥ 0.1 at time of CMVR diagnosis. Our study showed that CMVR was a rare complication after haploidentical HSCT but that the risk was greater in patients with multiple risk factors.
本研究调查了单倍体造血干细胞移植（HSCT）后巨细胞病毒性视网膜炎（CMVR）的流行病学特征。我们研究了2013年至2017年间连续接受单倍体HSCT的1466例患者队列。我们记录了31例患者发生的34次CMVR发作，移植后中位发病时间为167天。移植后1年CMVR的累积发病率为2.3%。多变量分析表明，100天时血小板植入失败、EBV血症、难治性或复发性CMV血症以及急性移植物抗宿主病与CMV血症患者发生CMVR有关。有≥3个危险因素（高风险）的患者1年CMVR发病率高于有≤2个危险因素（低风险）的患者（26.2%对0.6%，P＜0.001）。在发生CMVR的患者中，16次发作时视力（VA）改善，10次发作时视力保持稳定，8次发作时视力恶化。与VA改善相关的变量是CMVR诊断时VA≥0.1。我们的研究表明，CMVR是单倍体HSCT后一种罕见的并发症，但在有多种危险因素的患者中风险更大。
