慢性活动性 Epstein-Barr 病毒感染患者外周血淋巴细胞亚群的临床特征。

Clinical Characteristics of Peripheral Lymphocyte Subtypes in Chronic Active Epstein-Barr Virus Infection.

机构信息

Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Disease in Children, National Center for Children's Health, Ministry of Education, Beijing Children's Hospital, Capital Medical University, Beijing, China.

Hematologic Disease Laboratory, Beijing Pediatric Research Institute, Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, National Center for Children's Health, Key Laboratory of Major Disease in Children, Ministry of Education, Beijing Children's Hospital, Capital Medical University, Beijing, China.

出版信息

J Infect Dis. 2024 Jul 25;230(1):95-102. doi: 10.1093/infdis/jiad435.

DOI:10.1093/infdis/jiad435

PMID:39052717

Abstract

BACKGROUND

We aimed to analyze the clinical characteristics of peripheral Epstein-Barr virus (EBV)-infected lymphocyte subtypes in children with chronic active EBV infection (CAEBV).

METHODS

The levels of peripheral EBV infection of CD4+ T cells, CD8+ T cells, and CD56+ natural killer (NK) cells were determined by flow cytometry and quantitative polymerase chain reaction (qPCR) in patients with CAEBV from July 2017 to July 2022.

RESULTS

In total, 112 children with CAEBV were evaluated. Of these, CD4+ type, CD8+ type, and CD56+ type were defined in 44, 21, and 47 patients, respectively. Patients with CD8+ T-cell type had a significantly higher frequency of rash, while hepatomegaly was more common in patients with CD4+ T-cell type. Generally, patients with CD8+ T-cell type had the lowest overall survival rate (P = .017). Patients treated with chemotherapy and hematopoietic stem cell transplantation (HSCT) had a better prognosis (P = .001). In multivariate analysis, rash, hemophagocytic lymphohistiocytosis, CD8+ T-cell type, and no decrease of plasma EBV-DNA after treatment were independent indicators of poor prognosis (P = .002, .024, .022, and .012, respectively).

CONCLUSIONS

In children with CAEBV, rash was more frequent in patients with CD8+ T-cell type, whereas patients with CD4+ T-cell type were more likely to develop hepatomegaly. Patients with CD8+ T-cell type had a poor prognosis despite receiving chemotherapy or further HSCT.

摘要

背景

我们旨在分析儿童慢性活动性 EBV 感染（CAEBV）外周 EBV 感染的淋巴细胞亚型的临床特征。

方法

2017 年 7 月至 2022 年 7 月，通过流式细胞术和定量聚合酶链反应（qPCR）检测 CAEBV 患儿外周 EBV 感染 CD4+T 细胞、CD8+T 细胞和 CD56+自然杀伤（NK）细胞的水平。

结果

共评估了 112 例 CAEBV 患儿。其中，44 例为 CD4+型、21 例为 CD8+型、47 例为 CD56+型。CD8+T 细胞型患者皮疹发生率较高，而 CD4+T 细胞型患者肝肿大更为常见。一般来说，CD8+T 细胞型患者的总生存率最低（P=.017）。接受化疗和造血干细胞移植（HSCT）治疗的患者预后较好（P=.001）。多因素分析显示，皮疹、噬血细胞性淋巴组织细胞增生症、CD8+T 细胞型和治疗后血浆 EBV-DNA 无下降是预后不良的独立指标（P=.002、.024、.022 和.012）。