马立巴韦治疗异基因造血干细胞移植后难治与药物不耐受CMV血症和CMV病25例临床分析
Maribavir treatment for refractory and drug-intolerant cytomegalovirus viremia and disease after allogeneic hematopoietic stem cell transplantation:a clinical analysis of 25 cases
马薇 1魏志杰 2卢岳 2张建平 2孙瑞娟 2熊敏 2周葭蕤 2董磊 1薛松 3曹星玉2
作者信息
- 1. 河北燕达陆道培医院造血干细胞移植科,廊坊 065201
- 2. 河北燕达陆道培医院造血干细胞移植科,廊坊 065201;北京陆道培医院移植科,北京 100176
- 3. 北京陆道培医院移植科,北京 100176
- 折叠
摘要
目的 探讨马立巴韦治疗异基因造血干细胞移植(allo-HSCT)后难治性、对常规抗病毒药物不耐受的巨细胞病毒(cytomegalovirus,CMV)血症和CMV病的安全性和有效性.方法 回顾性分析2024年4月至2024年9月在河北燕达陆道培医院马立巴韦治疗allo-HSCT后的难治性、对常规抗病毒药物不耐受的CMV血症和CMV病的结局.结果 接受马立巴韦治疗的25例患者,其中亲缘单倍型移植21例,同胞全合移植2例,非血缘移植2例.1次移植21例,2次移植2例和3次移植2例.患者发生CMV血症的中位时间为移植后120.5(6～298)d,血浆CMV最高拷贝中位数为6 400(1 100～650 000)拷贝/ml.6例患者诊断CMV病.患者在CMV感染后的9.5(1～41)d开始使用马立巴韦.使用马立巴韦持续中位时间为11.5(6～43)d.25例患者治疗均有效.2例患者发生1级的味觉异常,1例发生2级骨髓抑制.结论 allo-HSCT后难治性、药物不耐受的CMV血症和CMV病患者应用马立巴韦治疗安全有效.
Abstract
Objective To investigate the safety and efficacy of maribavir for the treatment of CMV viremia and CMV disease refractory or intolerant to conventional antiviral drugs after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods This study retrospectively analyzed the clinical characteristics and outcomes of CMV viremia and CMV disease refractory or intolerant to conventional antiviral drugs after allo-HSCT treated with maribavir at Hebei Yanda Lu Daopei Hospital from April 2024 to September 2024.Result A total of 25 patients received maribavir,including 21 haploidentical transplants,two sibling HLA-matched transplants,and 2 HLA-matched unrelated transplants.Among them,21,2,and 2 patients received the first,second,and third transplants,respectively.The median time to the onset of CMV viremia and CMV disease was 120.5(6-298)days post-transplantation.The median peak plasma CMV copy number was 6 400 copies/ml(range:1 100-650 000 copies/ml).Six patients were diagnosed with CMV disease.Maribavir was administered after a median of 9.5(1-41)days after CMV infection.The median duration of maribavir administration was 11.5(6-43)days.Post-treatment,maribavir was effective in 25(100％)patients.Two patients experienced grade 1 taste abnormalities,and one patient experienced grade 2 myelosuppression.Conclusion The application of maribavir after allo-HSCT for treating refractory,drug-intolerant CMV viremia and CMV disease is safe and effective.
关键词
巨细胞病毒/异基因造血干细胞移植/马立巴韦Key words
Cytomegalovirus/Allogeneic hematopoietic stem cell transplantation/Maribavir引用本文复制引用
出版年
2024
NETL
NSTL
万方数据