Schmidt C A, Oettle H, Wilborn F, Jessen J, Timm H, Schwerdtfeger R, Oertel J, Siegert W
Abteilung für Innere Medizin und Poliklinik, Universitätsklinikum Rudolf Virchow, Freie Universität, Berlin, Germany.
Bone Marrow Transplant. 1994 Jan;13(1):71-5.
We prospectively monitored buffy coat leukocytes of 47 patients after 50 marrow transplantations (autologous n = 18, allogeneic n = 32) by polymerase chain reaction (PCR) for the presence of cytomegalovirus (CMV). None of the 18 autologous graft recipients (9 seropositive, 9 seronegative) had positive PCR results or CMV disease throughout the post-transplantation course. Six of 32 allograft recipients (19 seropositive, 13 seronegative) became PCR positive, four of whom developed CMV disease. PCR positive patients were found more often (5 of 10) in the group with acute GVHD grade II-IV compared with 1 of 22 in the group without or with grade I acute GVHD (p = 0.002). Comparison of PCR with antigen assay and virus culture showed an agreement in 90 of 96 (94%) samples. Discordant results were due to a higher sensitivity of the PCR compared with antigen assay (n = 4) and virus culture (n = 6). In conclusion, PCR helps to identify those patients who will not develop CMV disease and narrows down the number of patients who eventually will suffer symptomatic CMV infection. Furthermore, PCR is a useful tool for following the post-transplantation course with respect to CMV and for judging the effect of antiviral treatment.
我们通过聚合酶链反应（PCR）对50例骨髓移植后的47例患者（自体移植18例，异体移植32例）的血沉棕黄层白细胞进行前瞻性监测，以检测是否存在巨细胞病毒（CMV）。18例自体移植受者（9例血清阳性，9例血清阴性）在整个移植后过程中PCR结果均为阴性，也未发生CMV疾病。32例异体移植受者中有6例（19例血清阳性，13例血清阴性）PCR结果呈阳性，其中4例发生了CMV疾病。与无急性移植物抗宿主病（GVHD）或有I级急性GVHD的组中22例中的1例相比，急性GVHD II-IV级组中PCR阳性患者更常见（10例中有5例）（p = 0.002）。PCR与抗原检测和病毒培养的比较显示，96份样本中有90份（94%）结果一致。结果不一致是由于PCR的敏感性高于抗原检测（4例）和病毒培养（6例）。总之，PCR有助于识别那些不会发生CMV疾病的患者，并减少最终会发生有症状CMV感染的患者数量。此外，PCR是监测移植后CMV病程以及判断抗病毒治疗效果的有用工具。
