新疆地区儿童异基因造血干细胞移植后巨细胞病毒感染相关危险因素分析

Analysis of risk factors associated with cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation in children of Xinjiang

目的分析儿童异基因造血干细胞移植(HSCT)后巨细胞病毒(CMV)感染首次发生的相关危险因素。方法通过回顾性分析2018年02月—2021年09月在新疆维吾尔自治区人民医院行异基因造血干细胞移植的患儿62例,随访至移植+100d,应用χ^(2)检验及Logistics回归模型,分析CMV感染发生的危险因素。结果62例患儿中共有36例(58.1%)在移植+100d内首次发生CMV感染,感染发生的中位时间为+38(23.5~56.8)d,单因素分析结果显示,干细胞来源、急性移植物抗宿主病(aGVHD)与CMV感染相关(P<0.05),多因素分析结果显示,Ⅰ-Ⅱ度aGVHD(OR,22.025,95%CI,4.144~117.060)、Ⅲ-Ⅳ度aGVHD(OR,12.082,95%CI,1.144~127.653)P值均<0.05,与CMV感染独立相关。结论儿童异基因造血干细胞移植后aGVHD与CMV感染的发生相关,应在移植早期得到足够的重视。

Objective To analyze the risk factors associated with the first occurrence of cytomegalovirus(CMV)infection after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children.Methods The risk factors for the development of CMV infection were analyzed by retrospectively analyzing 62 children who underwent allogeneic hematopoietic stem cell transplantation at the People′s Hospital of Xinjiang Uygur Autonomous Region from Feb.2018 to Sep.2021,with a follow-up period up to+100 d after transplantation,usingχ^(2) test and Logistics regression model.Results A total of 36 in 62 children(58.1%)had their first CMV infection within+100 d after transplantation,and the time to infection was+38 d(23.5-56.75).Stem cell origin and acute graft-versus-host disease(aGVHD)were associated with CMV infection in univariate analysis(P<0.05).Multifactorial analysis showed that degreeⅠ-ⅡaGVHD(OR,22.025,95%CI,4.144~117.060)and degreeⅢ-ⅣaGVHD(OR,12.082,95%CI,1.144~127.653)were independently associated with CMV infection(all P<0.05).Conclusions For children,aGVHD after allogeneic hematopoietic stem cell transplantation is associated with the development of CMV infection and should be given early clinical attention and prevention.