Takenaka K, Gondo H, Tanimoto K, Nagafuji K, Fujisaki T, Mizuno S, Miyamoto T, Okamura T, Hayashi S, Eto T, Osaki K, Yamasaki K, Shibuya T, Harada N, Teshima T, Matsuishi E, Minematsu T, Minamishima Y, Harada M, Niho Y
First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Japan.
Bone Marrow Transplant. 1997 Feb;19(3):241-8. doi: 10.1038/sj.bmt.1700637.
Cytomegalovirus (CMV) infection and CMV-associated disease were monitored using the CMV antigenemia assay in 72 patients who received allogeneic bone marrow transplantation (BMT), and their incidences were compared between related and unrelated donor transplant patients. The incidence of CMV infection after BMT was significantly higher in patients who received transplants from HLA-matched unrelated donors than from HLA-matched sibling donors (87% vs 53%, P < 0.05). CMV-associated disease developed in 73% of unrelated and in 14% of sibling donor transplant patients (P < 0.01). The peak levels of CMV antigenemia were significantly higher in unrelated donors than in sibling donor transplant patients (16 vs 1 CMV antigen-positive cells per 50000 WBCs, P < 0.01). The median number of CMV antigen-positive cells on first detection was also significantly higher in unrelated donor transplant patients (15 vs 1, P < 0.01). The detection of CMV antigen-positive cells preceded the development of CMV-associated disease in 18% of unrelated donor transplant patients, suggesting a lower predictive value of CMV antigenemia for subsequent CMV-associated disease in unrelated donor BMT. Careful monitoring and further studies are needed for the early diagnosis and prevention of CMV-associated disease in unrelated donor BMT.
采用巨细胞病毒（CMV）血症检测法对72例接受异基因骨髓移植（BMT）的患者进行CMV感染及CMV相关疾病监测，并比较了亲属供体和非亲属供体移植患者的发病率。接受HLA配型相合的非亲属供体移植的患者BMT后CMV感染的发生率显著高于接受HLA配型相合的同胞供体移植的患者（87%对53%，P<0.05）。73%的非亲属供体移植患者和14%的同胞供体移植患者发生了CMV相关疾病（P<0.01）。非亲属供体移植患者的CMV血症峰值水平显著高于同胞供体移植患者（每50000个白细胞中CMV抗原阳性细胞数分别为16个和1个，P<0.01）。首次检测时CMV抗原阳性细胞的中位数在非亲属供体移植患者中也显著更高（15对1，P<0.01）。18%的非亲属供体移植患者在CMV相关疾病发生前检测到CMV抗原阳性细胞，提示在非亲属供体BMT中CMV血症对后续CMV相关疾病的预测价值较低。对于非亲属供体BMT中CMV相关疾病的早期诊断和预防，需要进行仔细监测和进一步研究。
