Department of Medical Oncology and Hematology, Faculty of Medicine, Oita University, Hasama-Machi, Yufu, Oita, 879-5593, Japan.
Research Center for GLOBAL and LOCAL Infectious Diseases, Oita University, Oita, Japan.
Int J Hematol. 2024 Apr;119(4):432-441. doi: 10.1007/s12185-024-03714-2. Epub 2024 Feb 26.
This prospective multicenter study aimed to determine the effects of human herpesvirus-6B (HHV-6B) reactivation on central nervous system (CNS) function in cord blood transplant (CBT) recipients. Our focus was to track HHV-6B reactivation and evaluate its association with delirium and cognitive function, specifically in the domains of verbal memory, attention/processing speed, and quality of life (QOL). A cohort of 38 patients participated in this study. Of the 37 patients evaluated, seven (18.9%) developed delirium, with six of these cases emerging after HHV-6B reactivation (median lag, 7 days). Evaluation of verbal memory showed that the final trial score for unrelated words at 70 days after transplantation was significantly lower than that before preconditioning (P = 0.004) among patients (n = 15) who experienced higher-level HHV-6B reactivation (median or higher maximum plasma HHV-6 DNA load for participating patients). Patients without higher-level reactivation did not show significant declines in verbal memory scores. QOL was assessed using the 36-item Short-Form Health Survey, and the social functioning score 1 year post-transplantation was significantly lower in patients who experienced higher-level HHV-6B reactivation than in those who did not. Our findings suggest that higher-level HHV-6B reactivation can detrimentally affect certain cognitive functions in CBT recipients.
这项前瞻性多中心研究旨在确定人类疱疹病毒-6B(HHV-6B)再激活对脐带血移植(CBT)受者中枢神经系统(CNS)功能的影响。我们的重点是跟踪 HHV-6B 的再激活,并评估其与谵妄和认知功能的关联,特别是在语言记忆、注意力/处理速度和生活质量(QOL)领域。共有 38 名患者参与了这项研究。在 37 名接受评估的患者中,有 7 名(18.9%)出现了谵妄,其中 6 名患者在 HHV-6B 再激活后出现(中位滞后期为 7 天)。语言记忆评估显示,在移植后 70 天,接受更高水平 HHV-6B 再激活(对参与患者而言为中位数或更高的最大血浆 HHV-6 DNA 载量)的 15 名患者的无关联词最终试验评分明显低于预处理前(P=0.004)。未发生更高水平再激活的患者的语言记忆评分没有明显下降。使用 36 项简短健康调查问卷评估 QOL,在经历更高水平 HHV-6B 再激活的患者中,1 年后的社会功能评分明显低于未发生再激活的患者。我们的研究结果表明,更高水平的 HHV-6B 再激活会对 CBT 受者的某些认知功能产生不利影响。