异基因造血干细胞移植后EB病毒再激活的危险因素分析

背景：异基因造血干细胞移植后EB病毒再激活可导致致死性的移植后淋巴细胞增殖性疾病及相关疾病，目前国内尚未建立完整的EB病毒再激活及其相关性疾病的诊疗体系。 目的：前瞻性研究异基因造血干细胞移植后患者EB病毒再激活的发生和相关危险因素。 方法：纳入129例接受异基因造血干细胞移植的患者，采用实时定量PCR方法定期测定外周血中EB病毒载量，Kaplan-Meier模型分析其再激活的发生率，Logistic回归分析模型分析其再激活的相关危险因素。 结果与结论：异基因造血干细胞移植后EB病毒再激活及其相关疾病发生率高，EB病毒再激活发生的危险因素有HLA配型不合、应用抗胸腺细胞球蛋白、Ⅲ~Ⅳ度急性移植物抗宿主病及年龄小于20岁。

the National High-Tech Research and Development Plan of China, No. 2006AA02Z4A0*; the National Natural Science Foundation of China, No. 30971300*

BACKGROUND: Epstein-barr virus (EBV) reactivation following allogeneic hematopoietic stem cell transplantation (allo-HSCT) can cause deadly post-transplant lymphoproliferative disorders and other EBV-associated diseases. At present, a complete diagnosis and treatment system about EBV reactivation and EBV-related disease has not been established in China. OBJECTIVE: To investigate prospectively the incidence of EBV reactivation and risk factors following allo-HSCT. METHODS: 129 patients receiving allo-HSCT were included. EBV-DNA in peripheral blood were detected by real-time PCR; Kaplan-Meier model was used for analyzing cumulative incidence of EBV reactivation, and binary logistic regression model was used for analyzing risk factors of EBV reactivation. RESULTS AND CONCLUSION: EBV reactivation and EBV associated disease have high incidence rate after allo-HSCT. Risk factors for EBV reactivation include HLA mismatched, use of antithymocyte globulin, grade III-IV acute graft-versus-host disease and age less than or equal to 20 years old.