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论文摘要

异基因造血干细胞移植后巨细胞病毒感染的研究现状

Research status of cytomegalovirus infection following allogenic hematopoietic stem cell transplantation

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收稿日期:2020-05-20          年卷(期)页码:2020,43(05):374-382

期刊名称:国际输血及血液学杂志

Journal Name:International Journal of Blood Transfusion and Hematology

关键字:造血干细胞移植,移植,同种,巨细胞病毒感染,危险因素,抗病毒药

Key words:Hematopoietic stem cell transplantation|Transplantation, homologous|Cytomegalovirus infection|Risk factors|Antiviral agents

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中文摘要

巨细胞病毒(CMV)感染是异基因造血干细胞移植(allo-HSCT)后的常见并发症。allo-HSCT后CMV感染患者的主要临床表现为肺部感染,胃、肠道炎症,脑炎,肝炎,视网膜炎及无症状CMV血症等。CMV感染还可影响患者的免疫功能,增加细菌、真菌等病原菌感染风险,以及移植物抗宿主病(GVHD)和骨髓衰竭的发生风险。近年来,由于对allo-HSCT后患者预防性使用抗病毒药物,其CMV感染发生率有所下降。然而,多药耐药的出现及复发/难治性CMV感染,仍然严重影响allo-HSCT患者预后。笔者拟就allo-HSCT后CMV感染的危险因素、检测与诊断方法、预防及治疗等方面进行阐述,旨在为allo-HSCT后CMV感染的防治提供新思路。

英文摘要

Cytomegalovirus (CMV) infection is a common complication after allogenic hematopoietic stem cell transplantation (allo-HSCT). Clinical manifestations of patients with CMV infection after allo-HSCT mainly include pneumonia, gastrointestinal inflammation, encephalitis, hepatitis, retinitis, asymptomatic CMV viremia and so on. Furthermore, CMV infection can affect immune function of patients, which increases the chance of bacterial, fungal infection, as well as the risk of graft versus host disease (GVHD) and bone marrow failure. In recent years, the incidence of CMV infection has decreased due to the prophylactic use of antiviral drugs after allo-HSCT. However, the emergence of multi-drug resistance and recurrent/refractory CMV infection still seriously affect the prognosis of patients after allo-HSCT. This article discusses the risk factors, detection and diagnosis methods, prevention and treatment of CMV infection following allo-HSCT, in order to provide new thoughts for the prevention and therapy of CMV infection following allo-HSCT.

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