Ljungman P
Department of Hematology, Huddinge University Hospital, Sweden.
Bone Marrow Transplant. 1998 Apr;21 Suppl 2:S72-4.
Viral infections are important in SCT patients. Different viruses are challenges for the physician at different times after transplantation due to changing defects in the immune status of the patients. Infections with respiratory viruses in particular respiratory syncytial virus are important early after transplant but the knowledge about epidemiology, risk factors, and treatment is still limited. Parainfluenza and influenza viruses can also cause severe and sometimes fatal infections after SCT. During the acute GVHD phase, CMV has been the most important viral infection during the entire history of allogeneic SCT. Recent developments with antiviral prophylaxis, new techniques for early diagnosis, and the strategy of preemptive antiviral therapy has reduced its importance in matched sibling transplants. Instead CMV disease occurring late after SCT has become an increasingly important problem in patients who have undergone unrelated or mis-matched SCT due to poor development of T-cell function. Other herpesviruses such as human herpesvirus type 6 and EBV are also becoming important causes of severe complications after unrelated and mismatched SCT. For this group of patients new innovative preventive and therapeutic strategies are needed.
病毒感染在异基因造血干细胞移植（SCT）患者中很重要。由于患者免疫状态的缺陷不断变化，不同的病毒在移植后的不同时间给医生带来挑战。特别是呼吸道病毒感染，尤其是呼吸道合胞病毒感染，在移植后早期很重要，但关于其流行病学、危险因素和治疗的知识仍然有限。副流感病毒和流感病毒在SCT后也可引起严重的、有时甚至是致命的感染。在急性移植物抗宿主病（GVHD）阶段，巨细胞病毒（CMV）在异基因SCT的整个历史中一直是最重要的病毒感染。抗病毒预防的最新进展、早期诊断的新技术以及抢先抗病毒治疗策略降低了其在同胞全相合移植中的重要性。相反，SCT后晚期发生的CMV疾病在接受无关或配型不合SCT的患者中已成为一个日益重要的问题，这是由于T细胞功能发育不良所致。其他疱疹病毒，如人类疱疹病毒6型和EB病毒，在无关和配型不合的SCT后也正成为严重并发症的重要原因。对于这组患者，需要新的创新性预防和治疗策略。
