异基因造血干细胞移植后早期深部真菌感染风险因素分析

目的提高对异基因造血干细胞移植后早期深部真菌感染风险的认识。方法分析22例异基因造血干细胞移植患者的移植方式、病程、白细胞植入时间、移植后白细胞计数与早期深部真菌感染的相关性。结果6例患者异基因造血干细胞移植后早期发生深部真菌感染。采用半相合和无关供者的造血干细胞移植的患者深部真菌感染发生率明显高于全相合亲缘供者的造血干细胞移植,使用过兔抗人胸腺淋巴细胞球蛋白(ATG)或猪抗人淋巴细胞球蛋白(ALG)的患者,深部真菌感染发生率明显高于未使用者。在全相合的亲缘供者的造血干细胞移植中,真菌感染与非感染患者移植后0和14d白细胞计数存在显著性差异,而两组患者移植前病程和移植后7、21 d的白细胞计数差异无显著性。结论移植方式、使用ATG或ALG、移植后0和14 d白细胞数是移植后早期深部真菌感染发生的危险因素。

Analysis on risk of invasive fungal infection at phase of preengraftment of allogeneic hematopoietic stem cell transplantation

Objective To understand the risk of invasive fungal infection at phase of preengraft- ment of allogeneic hematopoietic stem cell transplantation(HSCT).Method The correlation between invasive fungal infection and mode of transplantation,course of disease,neutrophil engraftment,leuko- cyte count at day 0,7,14 and 21 days after HSCT was analyzed.Results Among 22 cases,6 cases de- veloped invasive fungal infection.The rate of invasive fungal infection of unrelated bone marrow trans- plants and haploidentical donor transplants was higher than that of related transplants.The rate of in- vasive fungal infection in the cases of ATG or ALG was higher than that in the cases without ATG or ALG.Among related HSCT,there was significant difference at day 0 and 14 after HSCT between the cases of fungal infection and those without fungal infection.Conclusion Mode of transplantation,neu- trophil engraftment,leukocyte count at day 0 and 14 after HSCT and use of ATG or ALG influences invasive fungal infection.