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单倍体相合造血干细胞移植后CD34+细胞剂量与巨细胞病毒血症:一项回顾性研究

CD34+ cell dose and CMV viremia after haploidentical hematopoietic stem cell transplantation: a retrospective study.

作者信息

Yan Peirou, Pan Xinan, Hao Qi, Wang Jingbo

机构信息

Aerospace Center Hospital Beijing, China.

Peking University People's Hospital Beijing, China.

出版信息

Am J Transl Res. 2024 Sep 15;16(9):5130-5136. doi: 10.62347/SOPM3064. eCollection 2024.

DOI:10.62347/SOPM3064
PMID:39398542
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11470346/
Abstract

BACKGROUND

Patients with hematologic malignancies who undergo Haplo-HSCT (Haploidentical hematopoietic stem cell transplantation) are at a significantly higher risk for CMV (Cytomegalovirus) infection than individuals with normal immune function. This increased susceptibility to CMV is a major contributor to the morbidity and mortality seen in patients following hematopoietic stem cell transplantation.

METHODS

This study involved a retrospective analysis of 113 patients who underwent allogeneic hematopoietic stem cell transplantation for malignant hematological diseases. Relevant variables were assessed through univariate analysis, and those identified in the previous literature as potential influencers of the occurrence of CMV viremia were also included in the multivariate regression analysis.

RESULTS

Among the 113 patients with malignant hematologic diseases undergoing Haplo-HSCT, 56 cases (49.56%) were identified with CMV viremia. Initial univariate analysis highlighted patient age, graft source, and CD34+ cell dose as risk factors for CMV viremia post-transplantation. However, subsequent logistic regression analysis revealed that CD34+ cell dose stood out as an independent protective factor against CMV viremia (OR = 0.797, 95% CI: 0.644-0.987, P = 0.037).

CONCLUSION

Our study reveals that a higher CD34 cell dosage serves as an independent protective factor against the development of CMV viremia after Haplo-HSCT in patients with hematologic malignancies.

摘要

背景

与免疫功能正常的个体相比,接受单倍体造血干细胞移植(Haploidentical hematopoietic stem cell transplantation,Haplo-HSCT)的血液系统恶性肿瘤患者发生巨细胞病毒(Cytomegalovirus,CMV)感染的风险显著更高。这种对CMV易感性的增加是造血干细胞移植后患者发病和死亡的主要原因。

方法

本研究对113例接受异基因造血干细胞移植治疗恶性血液病的患者进行了回顾性分析。通过单因素分析评估相关变量,先前文献中确定的可能影响CMV病毒血症发生的因素也纳入多因素回归分析。

结果

在113例接受Haplo-HSCT的恶性血液病患者中,56例(49.56%)被确定为发生了CMV病毒血症。最初的单因素分析强调患者年龄、移植物来源和CD34+细胞剂量是移植后CMV病毒血症的危险因素。然而,随后的逻辑回归分析显示,CD34+细胞剂量是预防CMV病毒血症的独立保护因素(OR = 0.797,95%CI:0.644 - 0.987,P = 0.037)。

结论

我们的研究表明,较高的CD34细胞剂量是血液系统恶性肿瘤患者接受Haplo-HSCT后预防CMV病毒血症发生的独立保护因素。

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本文引用的文献

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Risk factors for CMV infection within 100 days posttransplantation in patients with acute leukemia.急性白血病患者移植后100天内巨细胞病毒感染的危险因素。
Blood Sci. 2022 Jul 20;4(3):164-169. doi: 10.1097/BS9.0000000000000121. eCollection 2022 Jul.
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Low-dose IL-2 therapy restores imbalance between Th17 and regulatory T cells in patients with the dermatomyositis combined with EBV/CMV viremia.低剂量白细胞介素 2 治疗可恢复皮肌炎伴 EBV/CMV 血症患者中 Th17 与调节性 T 细胞之间的失衡。
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Higher Dose of CD34 cells Promotes Early Reconstitution of Natural Killer Cells and Is Associated with Better Outcomes After Unmanipulated Hematopoietic Stem Cell Transplantation for Myeloid Malignancies.高剂量 CD34 细胞促进自然杀伤细胞的早期重建,并与未经处理的造血干细胞移植治疗骨髓恶性肿瘤后的更好结局相关。
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The association of cytomegalovirus infection and cytomegalovirus serostatus with invasive fungal infections in allogeneic haematopoietic stem cell transplant recipients: a systematic review and meta-analysis.巨细胞病毒感染和巨细胞病毒血清状态与异基因造血干细胞移植受者侵袭性真菌感染的关系:系统评价和荟萃分析。
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Haploidentical donor transplant is associated with secondary poor graft function after allogeneic stem cell transplantation: A single-center retrospective study.单倍体相合供者移植与异基因造血干细胞移植后次级移植物功能不良相关:一项单中心回顾性研究。
Cancer Med. 2021 Dec;10(23):8497-8506. doi: 10.1002/cam4.4353. Epub 2021 Oct 20.
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Risk factors and associations with clinical outcomes of cytomegalovirus reactivation after haploidentical versus matched-sibling unmanipulated PBSCT in patients with hematologic malignancies.同种异体与同胞相合非清髓 PBSCT 后血液恶性肿瘤患者巨细胞病毒再激活的危险因素及与临床结局的相关性。
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