异基因外周血造血干细胞移植并巨细胞病毒感染的分析

Clinical study of cytomegalovirus infection in allogeneic peripheral blood stem cell transplantation

目的探讨异基因外周血造血干细胞移植（PBSCT）中对巨细胞病毒（CMV）感染的监测及早期干预性治疗的可行性。方法对2005年1月～2006年12月在上海交通大学附属第一人民医院接受异基因PBSCT的35例患者进行回顾分析，分析CMV病的发生率及其相关的危险因素。结果35例患者中22例发生CMV血症，6例出现CMV病。其中2例发生CMV间质性肺炎（CMV—IP），均治疗无效死亡。通过CMV—DNA检测，对结果阳性而无临床症状者进行干预性治疗使CMV—DNA转阴，同时减少可能导致CMV病发生的高危因素，则可降低CMV病发生率。结论CMV病是异基因PBSCT的常见并发症，也是主要致死原因之一。本组所采用的方法可减少CMV病的发生率及CMV病的病死率。

Objective To explore feasibility of pre - emptive therapy of cytomegalovirus （CMV） infection in allogeneic peripheral blood stem cell transplantation. Methods Thirty - five allogeneic PBSCT patients in First People＇ s Hospital affiliated to Shanghai Jiaotong University. Performed between January 2005 and December 2006, were analyzed retrospectively . To study the morbidity and risk factors of CMV diseases. Results In 35 patients, 22 cases had CMV - DNA positively, 6 cases had CMV diseases, 2 of them with CMV interstitial pneumonia （ CMV - IP）. died. Patient with positive plasma CMV - DNA received pre - emptive therapy till their plasma CMV - DNA turned negative. Conclusion Plasma CMV - DNA monitoring and pre - emptive therapy could reduce the morbidity and mortality of CMV diseases, in allogeneic PBSCT patients.