更昔洛韦治疗异基因脐血移植术后受者巨细胞病毒抗原血症的研究

Clinical study of the ganciclovir in treatment of cytomegalovirus antigenemia in patients received allogenic umbilical cord blood transplantation

目的 研究更昔洛韦 (丽科伟 )对异基因脐血移植术后受者巨细胞病毒抗原血症的临床疗效和不良反应 ,探讨预防巨细胞病毒相关性间质性肺炎的理想用药时机及方法。 方法 12例异基因脐血移植受者 ,在移植后出现CMV Ag阳性 ,即给予更昔洛韦治疗 ,诱导治疗 5mg/ (kg·次 ) ,IV ,q 12h ,用药 2周 ,维持治疗 5mg/ (kg·d) ,IV ,qd ,每周用药 5d ,疗程 2～ 3周。 结果 对CMV Ag阴转比例 11/ 12 ;不良反应主要有胃肠不适、肝功能轻度异常 ,且不良反应均在停药后顺利恢复 ,无白细胞减少。 2例治疗前白细胞和血小板持续下降 ,在治疗后白细胞和血小板逐渐恢复正常。 结论 更昔洛韦治疗异基因脐血移植术后受者巨细胞病毒抗原血症的疗效肯定 ,不良反应轻微 ,可作为CMV IP的预防用药。

Objective To explore the efficacy and adverse reaction of ganciclovir in treatment of cytomegalovirus antigenemia after allogenic umbilical cord blood transplantation.Methods Twelve patients with cytomegalovirus antigenemia were treated with ganciclovir [5?mg/kg iv twice a day for 2 weeks,followed by 5?mg/(kg·d) iv five a week for 2～3 weeks].Results The eradication rate for cytomegalovirus antigenemia was 917%,the main side effects were GI symptoms and the light liver function damage,all side effects were relieved after stopping treatment,no leukopenia occurred,2 patients with leukopenia and thrombocytopenia at the beginning of treatment had gradually gotten normal after gancielovir treatment.Conclusion Ganciclovir is an effective agent for treatment of cytomegalovirus antigenemia after allogenic umbilical cord blood transplantation with mild adverse reactions.