Perruccio Katia, Ward Katherine N, Tridello Gloria, Knelange Nina, Zeiser Robert, Franke Georg-Nikolaus, Sirvent Anne, Einsele Hermann, Vicent Marta Gonzalez, Navarro Jose Maria Fernandez, Contentin Nathalie, Collin Matthew, Martino Rodrigo, Gambella Massimiliano, Sengeloev Henrik, Passweg Jakob, Snowden John, Nagler Arnon, Kulagin Alexander, Gabriel Melissa, Kröger Nicolaus, Pascual Cascon Maria Jesus, Yeshurun Moshe, Güngör Tayfun, Robin Christine, Clark Andrew, Lopez Duarte Monica, Amor Adrian Alegre, Itala-Remes Maija, Mikulska Malgorzata, Styczynski Jan, de la Camara Rafael, Ljungman Per, Averbuch Dina, Cesaro Simone
Pediatric Oncology Hematology, Santa Maria della Misericordia Hospital, Perugia, Italy.
Department of Infection and Immunity, University College, London, UK.
Bone Marrow Transplant. 2025 Jun 3. doi: 10.1038/s41409-025-02638-7.
Human herpes virus-6 (HHV-6) is the main cause of viral encephalitis in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). From January 2005 to December 2014, 97 patients with HHV-6 encephalitis were reported in the EBMT registry. The incidence was 0.45% after the first allo-HCT and varied with the type of donor and of stem cell source: sibling donor 0.06%, unrelated donor 0.68%, haploidentical donor 0.51%, cord blood 2.14%, bone marrow 0.20%, peripheral blood 0.44%. HHV-6 encephalitis occurred at a median time of 31 days from allo-HCT (range 16-317 days). With a median follow-up of 5.28 years, the 5-yr OS was 24.7%. The causes of death were: disease relapse/progression 11, infection 23, non-infectious cause 33, not specified 5. Forty-four deaths (61.1%) occurred within 90 days from diagnosis of HHV-6 encephalitis and in 24 HHV-6 encephalitis was considered a contributory cause. Eight-seven patients received treatment mainly with foscarnet or ganciclovir. In multivariate analysis, bone marrow/peripheral blood stem cell source and nonmyeloablative conditioning regimen were significant factors for lower survival. In conclusion, the incidence of HHV-6 encephalitis was low but associated with high mortality irrespective of antiviral treatment. This confirms the need for further research in this setting.
人类疱疹病毒6型（HHV-6）是接受异基因造血细胞移植（allo-HCT）患者发生病毒性脑炎的主要原因。2005年1月至2014年12月，欧洲血液与骨髓移植协会（EBMT）登记处报告了97例HHV-6脑炎患者。首次allo-HCT后的发病率为0.45%，且因供体类型和干细胞来源而异：同胞供体为0.06%，无关供体为0.68%，单倍体相合供体为0.51%，脐血为2.14%，骨髓为0.20%，外周血为0.44%。HHV-6脑炎发生在allo-HCT后的中位时间为31天（范围16 - 317天）。中位随访5.28年，5年总生存率为24.7%。死亡原因如下：疾病复发/进展11例，感染23例，非感染性原因33例，未明确5例。44例死亡（61.1%）发生在诊断HHV-6脑炎后的90天内，其中24例中HHV-6脑炎被认为是一个促成因素。87例患者主要接受膦甲酸钠或更昔洛韦治疗。多因素分析显示，骨髓/外周血干细胞来源和非清髓性预处理方案是生存率较低的显著因素。总之，HHV-6脑炎的发病率较低，但无论抗病毒治疗如何，其死亡率都很高。这证实了在这种情况下需要进一步研究。
