Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Treatment of Hematological Disease, Beijing, China.
Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing, China.
Front Immunol. 2021 Feb 16;11:620891. doi: 10.3389/fimmu.2020.620891. eCollection 2020.
Reactivation of cytomegalovirus (CMV) or Epstein-Barr virus (EBV) is common after hematopoietic stem cell transplantation (HSCT). Previous researches have demonstrated that either CMV or EBV reactivation is associated with poor outcomes of HSCT. However, few studies investigate the impact of CMV and EBV co-reactivation after HSCT. In this study, we described the clinical characteristics of HSCT recipients with CMV and EBV co-reactivation (defined as CMV and EBV viremia occur at the same period of time). We conducted a longitudinal study of 247 patients who underwent HSCT in our center. A total of 24 (9.7%) patients had CMV and EBV co-reactivation. These patients showed higher incidence of viral pneumonitis (P=0.005). Patients with CMV and EBV co-reactivation had significant lower 1-year overall survival (OS) (P=0.004) and lower 1-year leukemia free survival (LFS) (P=0.016). Our further analysis suggested that duration of CMV (P=0.014), EBV (P<0.001), and CD4+CD25+ T cell counts at day 30 post-transplantation (P=0.05) are independent risk factors of virus co-reactivation. In conclusion, patients who developed co-reactivation of CMV and EBV had poor prognosis in terms of lower 1-year OS and LFS, and the CMV and EBV co-reactivation was associated with prolonged CMV or EBV duration and poor CD4+CD25+ T cell reconstitution at day 30 post-transplantation.
巨细胞病毒（CMV）或 Epstein-Barr 病毒（EBV）在造血干细胞移植（HSCT）后再激活很常见。先前的研究表明，CMV 或 EBV 的再激活与 HSCT 的不良结局有关。然而，很少有研究探讨 HSCT 后 CMV 和 EBV 共同再激活的影响。在这项研究中，我们描述了 HSCT 受者中 CMV 和 EBV 共同再激活（定义为 CMV 和 EBV 病毒血症同时发生）的临床特征。我们对在我们中心接受 HSCT 的 247 例患者进行了一项纵向研究。共有 24 例（9.7%）患者出现 CMV 和 EBV 共同再激活。这些患者病毒性肺炎的发生率更高（P=0.005）。CMV 和 EBV 共同再激活的患者 1 年总生存率（OS）显著降低（P=0.004），无白血病生存率（LFS）显著降低（P=0.016）。我们的进一步分析表明，CMV 持续时间（P=0.014）、EBV 持续时间（P<0.001）以及移植后 30 天 CD4+CD25+T 细胞计数（P=0.05）是病毒共同再激活的独立危险因素。总之，发生 CMV 和 EBV 共同再激活的患者 1 年 OS 和 LFS 较差，CMV 和 EBV 共同再激活与 CMV 或 EBV 持续时间延长以及移植后 30 天 CD4+CD25+T 细胞重建不良有关。
