Miguel Salavert Lletí. Unidad de Enfermedades Infecciosas. Hospital Universitario y Politécnico La Fe, Valencia. Av. Fernando Abril Martorell, nº 106. Valencia 46016. Spain.
Rev Esp Quimioter. 2022 Oct;35 Suppl 3(Suppl 3):74-79. doi: 10.37201/req/s03.16.2022. Epub 2022 Oct 24.
Little evidence is available regarding the incidence of CMV disease in patients with solid cancers. Latest data show that approximately 50 % of these patients with CMV PCR positivity developed clinically relevant CMV-viremia, and would require specific therapy. In the clinical arena, CMV reactivation is an important differential diagnosis in the infectological work up of these patients, but guidelines of management on this subject are not yet available. CMV reactivation should be considered during differential diagnosis for patients with a severe decline in lymphocyte counts when receiving chemoradiotherapy or immunochemotherapy with lymphocyte-depleting or blocking agents. Monitoring of CMV reactivation followed by the implementation of preemptive strategies or the establishment of early antiviral treatment improves the prognosis and reduces the morbidity and mortality of these patients.
有关实体瘤患者巨细胞病毒（CMV）病的发病率，目前仅有少量证据。最新数据显示，这些 CMV-PCR 阳性患者中约有 50%发生了有临床意义的 CMV 病毒血症，需要进行特定的治疗。在临床领域，CMV 再激活是这些患者感染性检查的重要鉴别诊断，但目前尚无关于该主题的管理指南。在接受放化疗或免疫化疗联合淋巴细胞耗竭或阻断剂治疗时，当淋巴细胞计数严重下降时，应考虑 CMV 再激活作为鉴别诊断的一个因素。监测 CMV 再激活，然后实施抢先策略或建立早期抗病毒治疗，可以改善这些患者的预后并降低发病率和死亡率。
