Boeckh M, Stevens-Ayers T, Bowden R A
Fred Hutchinson Cancer Research Center, Program in Infectious Diseases, Seattle, WA 98104, USA.
J Infect Dis. 1996 Nov;174(5):907-12. doi: 10.1093/infdis/174.5.907.
In a prospective study, the cytomegalovirus (CMV) pp65 antigenemia assay was compared with detection of CMV by blood culture in 67 consecutive CMV-seropositive patients undergoing autologous marrow or peripheral blood stem cell transplantation. Antigenemia occurred in 26 patients (38.8%) a median of 33 days (range, 12-74) after transplant. Viremia was detected in 5 patients (7.5%) a median of 30 days (range, 12-74) after transplant and was treated with ganciclovir in 3. Antigenemia occurred sporadically at low levels (< 5 positive cells/slide) in 19 patients (28.4%) and never resulted in CMV disease. Two of 7 patients who presented with or progressed to antigenemia of > 5 positive cells/slide developed fatal CMV pneumonia 8 days later. Neither patient had CMV viremia before onset of pneumonia. Thus, quantitative CMV pp65 antigenemia may be useful in guiding antiviral treatment in seropositive autograft recipients.
在一项前瞻性研究中，对67例接受自体骨髓或外周血干细胞移植的巨细胞病毒（CMV）血清学阳性患者，比较了CMV pp65抗原血症检测与血培养检测CMV的情况。26例患者（38.8%）出现抗原血症，移植后中位时间为33天（范围12 - 74天）。5例患者（7.5%）检测到病毒血症，移植后中位时间为30天（范围12 - 74天），其中3例接受更昔洛韦治疗。19例患者（28.4%）偶尔出现低水平（<5个阳性细胞/玻片）的抗原血症，且从未导致CMV疾病。7例出现或进展为>5个阳性细胞/玻片抗原血症的患者中有2例在8天后发生致命性CMV肺炎。肺炎发作前，这两名患者均无CMV病毒血症。因此，定量CMV pp65抗原血症可能有助于指导血清学阳性自体移植受者的抗病毒治疗。
