异基因造血干细胞移植术后EB病毒感染的临床分析
Clinical Analysis of Epstein-Barr Virus Infection after Allogeneic Hematopoietic Stem Cell Transplantation
刘兰香 1汪晶 1王利 1刘林 1王欣 1张红宾 1唐晓琼 1熊艺颖1
作者信息
- 1. 重庆医科大学附属第一医院血液内科,重庆 400016
- 折叠
摘要
目的:分析异基因造血干细胞移植(allo-HSCT)后EB病毒(EBV)感染发生的危险因素及对生存的影响.方法:回顾性分析2014年1月-2021年6月于本院进行首次allo-AHCT患者的临床资料.共纳入347例接受allo-HSCT的患者,根据是否感染EB病毒(EBV)将其分为EBV组(n=114)和Non-EBV组(n=233).统计患者allo-HSCT 术后EBV感染的发生情况并分析EBV感染的危险因素.结果:有114例(32.8％)患者发生EBV感染(外周血EBV-DNA均阳性),其中,88例(77.2％)发生在移植后100 d内.5例(1.44％)确诊为PTLD(post-transplant lymphoproliferative disorder).中位发病时间为移植后57(7-486)d.多因素分析结果显示,ATG/ATG-F的使用、CMV血症和Ⅲ-Ⅳ度aGVHD的发生是EBV感染的危险因素;此外,相对于BuCy,应用包含FA/CA的强化预处理方案者EBV感染的风险显著增高.结论:EBV感染是allo-HSCT术后常见并发症,强化预处理方案、ATG/ATG-F的使用、CMV血症和Ⅲ-Ⅳ度aGVHD的发生会增加allo-HSCT后EBV感染的风险.
Abstract
Objective:To analyze the risk factors of Epstein-Barr virus(EBV)infection after allogeneic hematopoietic stem cell transplantation(allo-HSCT)and its impact on survival.Methods:The clinical data of 347 patients who underwent their first allo-HSCT in our hospital from January 2014 to June 2021 were retrospectively analyzed.Patients were divided into EBV(n=114)and Non-EBV(n=233)groups according to whether they were infected with EBV.The incidence of EBV infection after allo-HSCT was calculated,and the risk factors of EBV infection were analyzed.Results:A total of 114(32.8％)patients presented EBV infection(all peripheral blood EBV-DNA were positive).EBV infection occurred in 88 patients within 100 days after transplantation,which accounted for 77.2％of all patients with EBV infection.5 cases(1.44％)were confirmed as post-transplant lymphoproliferative disorder(PTLD).The median onset time of patients was 57(7-486)days after transplantation.Multivariate analysis showed that the use of ATG/ATG-F,occurrence of CMV viremia,and grade Ⅲ-Ⅳ aGVHD were risk factors for EBV infection.Furthermore,compared to BUCY,the use of intensified preconditioning regimens containing FA/CA was significantly increased the risk of EBV infection.Conclusion:EBV infection is a common complication after allo-HSCT.Intensified preconditioning regimens,use of ATG/ATG-F,CMV viremia and grade Ⅲ to Ⅳ aGVHD increase the risk of EBV infection after allo-HSCT.
关键词
异基因造血干细胞移植/EB病毒感染/危险因素Key words
allogeneic hematopoietic stem cell transplantation/EBV infection/risk factors引用本文复制引用
基金项目
重庆医科大学附属第一医院学科创新基金学科培育项目(03010203XKTS192)
出版年
2024
NETL
NSTL
万方数据