异基因造血干细胞移植后巨细胞病毒感染易感因素及防治研究进展

Research Progress on Predisposing Factors and Prevention of Cytomegalovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation

异基因造血干细胞移植(allo-HSCT)是治疗恶性血液系统疾病最为有效的方法。而CMV感染是该过程后常见的感染性并发症之一,可能导致组织侵入性疾病,并增加移植后急、慢性移植物抗宿主病(GVHD)、其他机会性感染和医疗负担。这对发病率、死亡率和移植物存活率产生重大影响,甚至对患者构成致命风险。CMV终末器官疾病的致死率高,预后差。现已有定量诊断检测和治疗CMV的抗病毒疗法,但由于副作用和耐药性,应用受限。因此,如何保护患者平安度过感染的窗口期,是亟需解决的关键问题。本综述将就此问题进行讨论。

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the most effective treatment for hematologic malignancies. CMV infection is a common infectious complication of the process, leading to tissue invasive disease and increasing post-transplant acute and chronic graft-versus-host dis-ease (GVHD), other opportunistic infections, and medical burden. This has a significant impact on morbidity, mortality, and graft survival, and even poses a fatal risk to patients. CMV end-organ dis-eases have a high fatality rate and poor prognosis. Antiviral therapies for the treatment of CMV are available for quantitative diagnostic testing and treatment, but their use is limited due to side ef-fects and drug resistance. Therefore, how to protect patients safely through the window of infection is a key issue that needs to be solved urgently. This review will discuss this issue.