异基因造血干细胞移植后早期 CMV 复制的发生率及来特莫韦一级/二级预防的作用 - 一项单中心研究。
Incidence of CMV Replication and the Role of Letermovir Primary/Secondary Prophylaxis in the Early Phase After Allogeneic Hematopoietic Stem Cell Transplantation - A Single Centre Study.
机构信息
Division of Hematology, University Hospital Basel, Basel, Switzerland.
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
出版信息
Anticancer Res. 2020 Oct;40(10):5909-5917. doi: 10.21873/anticanres.14611.
BACKGROUND/AIM: Cytomegalovirus (CMV) replication may cause life-threatening complications after allogeneic haematopoietic stem cell transplantation (allo-HSCT). The aim of the study was to characterize CMV events, and the outcome of letermovir (LTV) CMV prophylaxis.
PATIENTS AND METHODS
In this retrospective analysis of patients treated with an allo-HSCT between 2010 and 2020, we determined plasma CMV events, as well as associated risk factors.
RESULTS
We identified 423 patients who had undergone allo-HSCT between 2010 and 2020. CMV DNAemia was found in 130/423 (30.7%) of patients. CMV reactivation rate was significantly higher in patients with acute graft-versus-host disease, HLA mismatch, and CMV IgG seropositivity of donors and recipients. Among 42 patients receiving LTV prophylaxis those, 5 (11.9%) showed CMV DNAemia under LTV versus 87/353 (24.6%) in a control group.
CONCLUSION
Despite the development of better approaches with weekly monitoring and early treatment initiation, CMV reactivations play an important role after allo-HSCT.
背景/目的：异基因造血干细胞移植（allo-HSCT）后，巨细胞病毒（CMV）复制可能导致危及生命的并发症。本研究的目的是描述 CMV 事件以及来特莫韦（LTV）CMV 预防的结果。
患者和方法
在这项对 2010 年至 2020 年间接受 allo-HSCT 治疗的患者进行的回顾性分析中，我们确定了血浆 CMV 事件以及相关的危险因素。
结果
我们确定了 423 例在 2010 年至 2020 年间接受 allo-HSCT 的患者。130/423（30.7%）的患者出现 CMV DNAemia。急性移植物抗宿主病、HLA 错配、供者和受者 CMV IgG 阳性的患者 CMV 再激活率显著更高。在接受 LTV 预防的 42 例患者中，5 例（11.9%）在 LTV 下出现 CMV DNAemia，而对照组 353 例中的 87 例（24.6%）出现 CMV DNAemia。
结论
尽管采用了每周监测和早期治疗的方法，但 CMV 再激活在 allo-HSCT 后仍然是一个重要的问题。
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