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首页> 外文学位 >High incidence of herpes zoster in nonmyeloablative hematopoietic stem cell transplantation.
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High incidence of herpes zoster in nonmyeloablative hematopoietic stem cell transplantation.

机译：非清髓性造血干细胞移植中带状疱疹高发。

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摘要

Background. Current guidelines in hematopoietic stem cell transplantation (HSCT) endorse antiviral prophylaxis for all recipients seropositive for varicella-zoster virus. Nonmyeloalative (NMA) regimens have expanded in the past decade, but few data exist in patients undergoing NMA HSCT to support such a recommendation. The objectives of this study were to describe the clinical features, incidence and risk factors for herpes zoster (HZ) in a homogenous cohort of NMA HSCT patients.;Methods. All patients undergoing NMA HSCT at Hopital Maisonneuve-Rosemont (Canada) between 7/2000-12/2008 were included. Patients received the same conditioning regimen (fludarabine and cyclophosphamide), followed by infusion of blood stem cells from an HLA-identical related donor. Tacrolimus and mycophenolate mofetil were used to prevent graft-vs.-host disease. CMV reactivation was monitored using a preemptive strategy; HSV-seropositive recipients received antiviral prophylaxis.;Results. A total of 179 patients were followed for 33 months (median, IQR: 21-59). HZ developed in 66 patients (37%) at a median of 8.3 months post-HSCT; the incidence rate was 175 cases/1,000 person-years. Thoracic dermatomes were most frequently involved (30%); dissemination occurred in 5 patients. No death resulted from HZ, but 23% developed post-herpetic neuralgia. The estimated cumulative HZ incidence was 27, 36, and 44% at 1, 2, and 3 years respectively. In multivariate analysis, CMV and HSV reactivation appeared protective against HZ (HR= 0.52 and 0.26, respectively).;Conclusion. The incidence of HZ in our study sample is similar to the incidence reported for myeloablative regimens. Antiviral treatment for viral reactivations protects against HZ. Antiviral prophylaxis for HZ for at least the 1st year post-transplantation, as recommended, would also apply to the NMA HSCT population.
机译：背景。现行的造血干细胞移植（HSCT）指南对所有对水痘带状疱疹病毒呈血清反应阳性的接受者都认可了抗病毒预防措施。在过去的十年中，非清髓性（NMA）方案得到了扩展，但是接受NMA HSCT的患者中很少有数据支持这一建议。这项研究的目的是描述同种NMA HSCT患者队列中带状疱疹（HZ）的临床特征，发生率和危险因素。包括所有在7 / 2000-12 / 2008之间在Hopital Maisonneuve-Rosemont（加拿大）接受NMA HSCT的患者。患者接受相同的调理方案（氟达拉滨和环磷酰胺），然后输注来自HLA相同相关供体的血干细胞。他克莫司和霉酚酸酯用于预防移植物抗宿主病。使用抢先策略监控CMV重新激活； HSV血清反应阳性的接受者接受了抗病毒药物预防。总共179例患者被随访33个月（中位数，IQR：21-59）。在HSCT后中位8.3个月，有66例患者（37％）出现HZ；发病率为175例/ 1,000人年。胸皮切开术最常见（30％）；传播发生5例。 HZ并未导致死亡，但23％的人患有疱疹后神经痛。在1年，2年和3年时，估计的HZ累积发生率分别为27％，36％和44％。在多变量分析中，CMV和HSV的再激活表现出对HZ的保护作用（HR分别为0.52和0.26）。在我们的研究样本中，HZ的发生率与清髓疗法报告的发生率相似。用于病毒激活的抗病毒治疗可预防HZ。根据建议，对于HZ至少应在移植后第一年进行抗病毒预防，这也适用于NMA HSCT人群。

著录项

  • 作者

    Su, Shih Hann.;

  • 作者单位

    Sackler School of Graduate Biomedical Sciences (Tufts University).;

  • 授予单位 Sackler School of Graduate Biomedical Sciences (Tufts University).;
  • 学科 Biology Virology.;Health Sciences Epidemiology.;Health Sciences Oncology.
  • 学位 M.S.
  • 年度 2010
  • 页码 41 p.
  • 总页数 41
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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