Panesso Melissa, Uría María Luz, Renedo Berta, Esperalba Juliana, Benítez-Carabante María Isabel, Mendoza-Palomar Natalia, Alonso Laura, Oliveras Maria, Diaz-de-Heredia Cristina
Division of Pediatric Oncology and Haematology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Institut de Recerca Vall d'Hebron, Barcelona, Spain.
Front Pediatr. 2023 Jul 24;11:1197828. doi: 10.3389/fped.2023.1197828. eCollection 2023.
Cytomegalovirus (CMV) is a major cause of allogeneic hematopoietic stem cell transplant (HSCT)-related morbidity and mortality. Treatment failure continues to be a major issue in patients with CMV infection due to both drug resistance and intolerance. This single-center brief retrospective analysis of a case series aims to investigate the safety and efficacy of CMV-hyperimmune globulin as salvage therapy for CMV infection in children undergoing HSCT. Fifteen pediatric patients received human CMV-specific immunoglobulin (CMVIG) between July 2018 and December 2021 as a salvage therapy for refractory or recurrent CMV infection. At the time of CMVIG prescription, eight children presented with recurrent CMV infection and seven with refractory CMV infection. The overall response rate was 67% at 50 days from the CMVIG administration [95% confidence interval (CI): 44-88]. Overall survival (OS) from CMVIG administration at 100 days was 87% (95% CI: 56-96), and OS from HSCT at 1 year was 80% (95% CI: 50-93). Four patients died, three unrelated to CMV infection and one due to CMV pneumonia. CMVIG as salvage therapy was well tolerated, and no infusion-related adverse events were observed.
巨细胞病毒（CMV）是异基因造血干细胞移植（HSCT）相关发病和死亡的主要原因。由于耐药性和不耐受性，治疗失败仍然是CMV感染患者的一个主要问题。本单中心对一系列病例的简要回顾性分析旨在研究CMV高免疫球蛋白作为挽救疗法治疗接受HSCT的儿童CMV感染的安全性和有效性。2018年7月至2021年12月期间，15名儿科患者接受了人CMV特异性免疫球蛋白（CMVIG）作为难治性或复发性CMV感染的挽救疗法。在开具CMVIG处方时，8名儿童出现复发性CMV感染，7名儿童出现难治性CMV感染。从CMVIG给药后50天的总体缓解率为67%[95%置信区间（CI）：44-88]。CMVIG给药后100天的总生存率（OS）为87%（95%CI：56-96），HSCT后1年的OS为80%（95%CI：50-93）。4名患者死亡，3名与CMV感染无关，1名死于CMV肺炎。CMVIG作为挽救疗法耐受性良好，未观察到与输注相关的不良事件。
