异基因造血干细胞移植治疗儿童肝炎后极重型再生障碍性贫血导致难治性巨细胞病毒肺炎所致死亡1例
A Case of Death Caused by Refractory Cytomegalovirus Pneumonia after Allogeneic Hematopoietic Stem Cell Transplantation for Treatment of Severe Aplastic Anemia after Hepatitis in Children
DOI: 10.12677/ACM.2023.133560, PDF,   
作者: 王亚宁：济宁医学院研究生院，山东 济宁；徐惠芳, 陈璐璐, 黄宗宣, 陶艳玲*：济宁医学院附属医院儿童血液科血液研究所，山东 济宁；张 颢：济宁医学院附属医院血液科，山东 济宁
关键词: 异基因；造血干细胞移植；再生障碍性贫血；巨细胞病毒感染；Allogeneic； Hematopoietic Stem Cell Transplantation； Aplastic Anemia； Cytomegalovirus Infection
摘要: 异基因造血干细胞移植(allo-HSCT)是再生障碍性贫血的重要治疗方法。常见的并发症是机会性感染和移植物抗宿主病(GVHD)。巨细胞病毒(CMV)是机会性感染最常见的原因之一，也是导致移植相关发病率和死亡率的重要原因。本文报道一例肝炎后再生障碍性贫血行异基因造血干细胞移植(亲缘半相合)术后巨细胞病毒感染所致重症肺炎导致死亡的患儿。给予早期、足量、联合、长期的抗病毒治疗后，仍不能阻止病毒在体内的复制，最终导致死亡。
Abstract: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an important treatment for aplastic anemia. Common complications are opportunistic infections and graft-versus-host disease (GVHD). Cytomegalovirus (CMV) is one of the most common causes of opportunistic infection and is an important cause of transplant-related morbidity and mortality. In this paper, a child with severe pneumonia due to cytomegalovirus infection following an allogeneic hematopoietic stem cell transplantation (relatives semi-conjugated) is reported in post-hepatitis aplastic anemia. After giving early, adequate, combined, long-term antiviral therapy, it still cannot stop the replication of the virus in the body, which eventually leads to death.
文章引用：王亚宁, 徐惠芳, 陈璐璐, 黄宗宣, 张颢, 陶艳玲. 异基因造血干细胞移植治疗儿童肝炎后极重型再生障碍性贫血导致难治性巨细胞病毒肺炎所致死亡1例[J]. 临床医学进展, 2023, 13(3): 3907-3910. https://doi.org/10.12677/ACM.2023.133560

参考文献

[1] Ren, L. and Liu, Q. (2013) Diagnosis and Treatment of Viral Diseases in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation. Journal of Hematology & Oncology, 6, Article No. 94. [Google Scholar] [CrossRef] [PubMed]
[2] Chan, S.T. and Logan, A.C. (2017) The Clinical Impact of Cyto-megalovirus Infection Following Allogeneic Hematopoietic Cell Transplantation: Why the Quest for Meaningful Prophylaxis Still Matters. Blood Reviews, 31, 173-183. [Google Scholar] [CrossRef] [PubMed]
[3] Michael, B., Wendy, L., Stanley, R.R., et al. (2003) Late Cyto-megalovirus Disease and Mortality in Recipients of Allogeneic Hematopoietic Stem Cell Transplants: Importance of Viral Load and T-Cell Immunity. Blood, 101, 407-414. [Google Scholar] [CrossRef] [PubMed]
[4] Zaia, J., Baden, L., Boeckh, M.J., et al. (2009) Viral Disease Prevention after Hematopoietic Cell Transplantation. Bone Marrow Transplant, 44, 471-482. [Google Scholar] [CrossRef] [PubMed]
[5] Emery, V., Zuckerman, M., Jackson, G., et al. (2013) Management of Cytomegalovirus Infection in Haemopoietic Stem Cell Transplantation. British Journal of Haematology, 162, 25-39. [Google Scholar] [CrossRef] [PubMed]
[6] Ljungman, P., Camara, R.D.L., Cordonnier, C., et al. (2008) Management of CMV, HHV-6, HHV-7 and Kaposi-Sarcoma Herpesvirus (HHV-8) Infections in Patients with Hematological Malig-nancies and after SCT. Bone Marrow Transplant, 42, 227-240. [Google Scholar] [CrossRef] [PubMed]
[7] Celilova, S., Toret, E., Adakl, B.A., et al. (2020) CMV-Specific T-Cells for Treatment of CMV Infection after Hematopoietic Stem Cell Transplantation in a Pediatric Case: First Application in Turkey. Turkish Journal of Hematology, 37, 57-76. [Google Scholar] [CrossRef] [PubMed]
[8] Ariza-Heredia, E.J., Lior, N. and Chemaly, R.F. (2014) Cytomegalovirus Diseases after Hematopoietic Stem Cell Transplantation: A Mini-Review. Cancer Letters, 342, 1-8. [Google Scholar] [CrossRef] [PubMed]
[9] Michael, B., William, J.M. and Karl, S.P. (2015) Reprint of: Re-cent Advances in Cytomegalovirus: An Update on Pharmacologic and Cellular Therapies. Biology of Blood and Marrow Transplantation, 21, 19-24. [Google Scholar] [CrossRef] [PubMed]
[10] Xu, Z., Huang, X., Sun, Y., et al. (2015) Cytomegalovirus Spe-cific Cytotoxic T Lymphocytes for Treatment of Refractory Cytomegalovirus Infection in Patients Following Allogeneic Hematopoietic Stem Cell Transplantation. Chinese Journal of Internal Medicine, 54, 101-105.
[11] Baldo, F., Suárez, N.M., Davison, A.J., et al. (2021) Post-HSCT Graft Failure Due to Refractory Human Cytomegalovirus Successfully Treated with Haploidentical Donor-Derived Immunoglobulins and Stem Cell Graft Infusion: A Case Report. Antiviral Research, 188, 105024. [Google Scholar] [CrossRef] [PubMed]
[12] Li, Q., Wang, K., Guo, W., et al. (2019) Cytomegalovirus Pneumonia in a Patient with T-Lymphoblastic Leukemia/Lymphoma after Allogeneic Hematopoietic Stem Cell Transplantation A Case Report. Medicine, 98, e14221. [Google Scholar] [CrossRef] 
[13] Ann, M.L., Catherine, M.B., Adam, M.M., et al. (2013) Multicenter Study of Banked Third-Party Virus-Specific T Cells to Treat Severe Viral Infections after Hematopoietic Stem Cell Transplantation. Blood, 121, 13-23.

为你推荐