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异基因造血干细胞移植后人类细小病毒B19感染的临床特征

[Clinical characteristics of human parvovirus B19 infection after allogeneic stem cell transplantation].

作者信息

Zhang J, Ma R, Luo X Y, Zhang X H, Xu L P, Wang Y, Mo X D, Lyu M, Liu K Y, Huang X J, Sun Y Q

机构信息

Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2024 Jun 14;45(6):591-593. doi: 10.3760/cma.j.cn121090-20231128-00284.

Abstract

Human parvovirus B19 (HPVB19) belongs to Parvoviridae, a genus of erythrovirus, and has been associated with various human diseases, and HPVB19 infection is one of the most important causes of refractory anemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study retrospectively analyzed 24 patients with HSCT combined with HPVB19 infection to collate and summarize the clinical presentation, treatment, and regression of patients with combined HPVB19 infection after allo-HSCT and provide experience in the management of HPVB19 infection after allo-HSCT. The median age of the patients with HPVB19 infection was 25 years, and the median time of infection occurrence was +107 days after transplantation, and 22 (91.7% ) had anemia with a median hemoglobin (HGB) level of 77.5 (46-149) g/L, and 13 (54.2% ) had new-onset anemia or persistent decline in HGB. The median length of hospital stay was 19 days. Among patients with new-onset anemia or persistent decline in HGB, the mean increase in HGB after treatment with intravenous immunoglobulin and/or antiviral therapy was 15.69 g/L, and treatment was effective in 10 (76.92% ) patients. HPVB19 infection should be alerted to the development of refractory anemia after HSCT; despite the lack of specific treatment, the overall prognosis of HPVB19-infected patients is good.

摘要

人细小病毒B19(HPVB19)属于细小病毒科,是红病毒属的一种,与多种人类疾病相关,并且HPVB19感染是异基因造血干细胞移植(allo - HSCT)后难治性贫血的最重要原因之一。本研究回顾性分析了24例allo - HSCT合并HPVB19感染的患者,以整理和总结allo - HSCT后合并HPVB19感染患者的临床表现、治疗及转归情况,为allo - HSCT后HPVB19感染的管理提供经验。HPVB19感染患者的中位年龄为25岁,感染发生的中位时间为移植后 +107天,22例(91.7%)出现贫血,血红蛋白(HGB)中位水平为77.5(46 - 149)g/L,13例(54.2%)出现新发贫血或HGB持续下降。中位住院时间为19天。在新发贫血或HGB持续下降的患者中,静脉注射免疫球蛋白和/或抗病毒治疗后HGB的平均升高值为15.69 g/L,10例(76.92%)患者治疗有效。应警惕HSCT后HPVB19感染导致难治性贫血的发生;尽管缺乏特异性治疗,但HPVB19感染患者的总体预后良好。

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