摘要
目的分析异基因造血干细胞移植(allo-HSCT)后EB病毒感染情况。方法回顾性分析2010年1月至2011年12月于北京大学血液病研究所行allo-HSCT患者的临床资料。结果720例患者中男469例,女251例,中位年龄30(2~67)岁,其中66例患者发生EBV感染,累积发生率为(9.3±1.1)%,中位发生时间54.5(18~253)d。在HLA全相合、HLA半相合及非血缘移植患者中移植后1年EBV感染累积发生率分别为(1.3±0.7)%、(13.7±1.7)%和(9.1±4.4)%。在其中HLA半相合移植中EBV血症、临床诊断EBV病及淋巴细胞增殖性疾病(PTLD)的累积发生率分别为(5.8±1.1)%、(5.7±1.1)%和(2.3±0.7)%。所有感染EBV患者的总病死率为(33.9±5.9)%,不同EBV疾病患者的病死率:PTLD为(63.6±15.8)%,临床诊断的EBV病为(42.3±9.9)%,单纯EBV血症为(13.8±6.5)%。单因素和多因素分析均显示预处理过程中使用抗胸腺细胞球蛋白(ATG)是allo—HSCT后EBV感染及EBV病发生的独立危险因素。结论EBV感染是allo-HSCT后常见的合并症,尤其是EBV相关疾病及PTLD的患者病死率高,其发生的独立危险因素是预处理过程中使用ATG。
Objective To analyze the prevalence of Epstein Barr Virus (EBV) in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods We retrospectively analyzed the clinical characteristics of 720 patients received allo-HSCT from January 2010 through December 2011 in the Stem Cell Transplant Center of People's Hospital. Results Of 720 patients (469 male presented and 251 females), with a median age of 30 years (range, 2 to 67 years) old, 66 patients were presented with EBV reactivation. The cumulative incidence of EBV reactivation was (9.3±1.1)%, with a median days of 54.5 (range, 18 to 253 days). During one-year post-transplantation, the cumulative incidences of EBV reactivation in sibling allo-HSCT, haplo-identical HSCT and unrelated donor HSCT were (1.3±0.7)%, (13.7±1.7)%, and (9.1±4.4)%, respectively. In patients with haplo-identical HSCT, the cumulative incidences of EBV viremia, probable EBV disease, and post-transplant lymphoproliferative disease (PTLD) were (5.8±1.1)%, (5.7±1.1)%, and (2.3±0.7)%. The mortality was (33.9±5.9)% in all patients with EBV infection: (63.6±15.8)% in PTLD, (42.3±9.9)% in probable EBV disease, (13.8±6.5)% in EBV viremia. By univariate and multivariate analysis, the use of ATG was an independent risk factor for EBV infection. Conclusion EBV reactivation is a common complication in patients with allo-HSCT, especially high mortality in PTLD and probable EBV disease. The use of ATG was an independent risk factor for EBV infection.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2013年第8期651-654,共4页
Chinese Journal of Hematology
基金
国家自然科学基金(30971292)
北京市自然科学基金(7122193)
关键词
EB病毒
EBV病
淋巴细胞增殖性疾病
造血干细胞移植
EB virus
EBV disease
Lymphoproliferative disease
Hematopoietic stem cell transplantation