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异基因造血干细胞移植受者巨细胞病毒感染的深入总结

In-depth summary over cytomegalovirus infection in allogeneic hematopoietic stem cell transplantation recipients.

作者信息

Karami Samira, Roshandel Elham, Ghaffari Nazari Haniyeh, Hajifathali Abbas, Tavakoli Farzaneh, Parkhideh Sayeh

机构信息

Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Virusdisease. 2021 Sep;32(3):422-434. doi: 10.1007/s13337-021-00728-w. Epub 2021 Jul 28.

Abstract

In this study, we reviewed various aspects of cytomegalovirus infection, including pathophysiology, diagnosis methods, and antiviral treatments. Background: Infections continue to be a major reason of complications like high non-relapse morbidity and mortality rate after allogenic hematopoietic stem cell transplantation. Cytomegalovirus is the most common infection in immunocompromised patients or those with graft-versus-host disease. The Latent-cytomegalovirus disease could increase the risk of reactivation in allogenic hematopoietic stem cell transplantation patients and lead to profound adverse effects on transplantation outcomes. Cytomegalovirus-specific CD4 + and CD8 + T cells reconstitution is crucial for protection against the virus reactivation. Different prophylactic, pre-emptive, and therapeutic anti-viral drugs are available to prevent cytomegalovirus infection/reactivation and treat resistant infections. Conclusion: Although there has been introduced various CMV antiviral treatment strategies like antiviral drugs, Vaccination, passive immunotherapies and adoptive transfer of CMV-specific T cells, further clinical trials are required to approve current therapies.

摘要

在本研究中,我们回顾了巨细胞病毒感染的各个方面,包括病理生理学、诊断方法和抗病毒治疗。背景:感染仍然是异基因造血干细胞移植后高非复发发病率和死亡率等并发症的主要原因。巨细胞病毒是免疫功能低下患者或患有移植物抗宿主病患者中最常见的感染。潜伏性巨细胞病毒病会增加异基因造血干细胞移植患者病毒再激活的风险,并对移植结果产生严重不利影响。巨细胞病毒特异性CD4 +和CD8 + T细胞重建对于预防病毒再激活至关重要。有不同的预防性、抢先性和治疗性抗病毒药物可用于预防巨细胞病毒感染/再激活并治疗耐药感染。结论:尽管已经引入了各种巨细胞病毒抗病毒治疗策略,如抗病毒药物、疫苗接种、被动免疫疗法和巨细胞病毒特异性T细胞的过继转移,但仍需要进一步的临床试验来批准当前的疗法。

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