国产膦甲酸钠治疗异基因外周血干细胞移植后受者巨细胞病毒抗原血症的临床观察

CLINICAL OBSERVATION OF THE EFFICACY OF DOMESTIC FOSCARNET IN TREATMENT OF CMV INFECTIONS IN PATIENTS RECEIVED ALLOGENIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION(ALLOPBSCT)

目的 :观察国产膦甲酸钠 (可耐 )对异基因外周血干细胞移植 (Allo PBSCT)后受者巨细胞病毒抗原血症(CMVpp6 5 )的临床疗效和不良反应 ,探索预防巨细胞病毒相关性间质性肺炎 (CMV IP)的理想用药时机及方法。方法 :10例Allo PBSCT受者 ,在移植后出现CMVpp6 5 ( +) ,即给予可耐 6 0mg/kg ,q8h ,连用 3周。 结果 :对CMVpp6 5转阴率 9/ 10 ;未转阴 1例出现CMV IP ;不良反应主要有胃肠不适 ,低钙、低钾、低镁血症 ( 3/ 10 ) ,1例出现末梢神经炎 ,全身浮肿 ;1例患者因反复下肢抽搐拒绝用药 ,退出观察。所有不良反应均在停药后缓解 ,无白细胞减少及肝肾功能异常。结论 :国产膦甲酸钠治疗异基因外周血干细胞移植后受者巨细胞病毒抗原血症疗效肯定 ,可作为CMV IP的预防治疗用药 ;不良反应轻微 ,因不引起白细胞减少 。

OBJECTIVE:To observe the efficacy and adverse reactions of domestic foscarnet in treatment of CMV pp65 antigenemia after AlloPBSCT.METHODS:Ten patients with CMV pp65 antigenemia were treated with 60 mg/kg foscarnet every 8h for 2～3 weeks.RESULTS:The eradication rate for CMV pp65 antigenemia was 90%. The main side effects were GI symptoms,hypocalcemia,hypokalcemia,hypomagnesemia,anasarca,1 patient withdrawn from observation because of convalsion.All side effects were relieved after stopping treatment.CONCLUSION: Domestic foscarnet is an effective agent for treatment of CMV pp65 antigenemia after AlloPBSCT with mild adverse reactions.