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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Early Use of Blood Purification in Severe Epstein-Barr Virus-Associated Hemophagocytic Syndrome
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Early Use of Blood Purification in Severe Epstein-Barr Virus-Associated Hemophagocytic Syndrome

机译：早期使用血液净化在严重的Epstein-Barr病毒相关血糖综合征中

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摘要

Early incorporation of PE and CRRT with HLH-2004 chemoimmunotherapy may be an effective solution for both short- and long-term control of patients with severe EBV-HLH. Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) is a common type of hemophagocytic lymphohistiocytosis (HLH) that exhibits high rates of morbidity and fatalities. Multiorgan failure caused by Epstein-Barr virus (EBV)-induced hypercytokinemia is one of the main reasons for early deaths. Blood purification techniques have been successfully applied in previously treated hypercytokinemia. However, there were insufficient studies to support the combination of plasma exchange (PE) and continuous renal replacement therapy (CRRT) in treating patients with severe EBV-HLH. In this article, we have summarized the effects of early incorporation of PE and CRRT, together with HLH-2004 chemoimmunotherapy, in 8 pediatric patients with severe EBV-HLH. Early use of PE and CRRT appeared to be well tolerated, and no serious side effects and early deaths were observed. After PE and CRRT procedures, cytokine levels were reduced to normal values, except for soluble interleukin 2 receptor, and significant reductions in EBV DNA, serum ferritin, aspartate transaminase, total bilirubin, total bile acid, lactate dehydrogenase, and body temperature values and increases in the neutrophil count in addition to hemoglobin, albumin, and cholinesterase values were observed. Furthermore, through continuous HLH-2004 treatment regimens, lower limits of detection were exhibited for EBV DNA levels, and all other observational indicator levels were restored to normal. Finally, 7 patients achieved and maintained complete remission for 15 to 24 months, culminating in August 2019. Therefore, it is our suggestion that early incorporation of PE and CRRT with chemoimmunotherapy might be a safe and effective treatment for patients with severe EBV-HLH.
机译：PE和CRRT的早期掺入HLH-2004 ChemoImmun疗法可能是对患有严重EBV-HLH的患者的短期和长期控制的有效解决方案。 Epstein-BARR病毒相关的血糖淋巴管肾小球菌（EBV-HLH）是一种常见的血糖淋巴管肾小球菌（HLH），其发病率高和死亡率高。 Epstein-Barr病毒（EBV）引起的多型失败 - 诱导的Hypercytokinemia是早期死亡的主要原因之一。已成功应用血液净化技术在先前治疗的Hypercytokinemia中。然而，没有足够的研究，以支持血浆交换（PE）和连续肾置换治疗（CRRT）的组合治疗严重EBV-HLH的患者。在本文中，我们总结了PE和CRRT早期掺入的影响，以及HLH-2004 ChemoImmun疗法，在8名严重EBV-HLH的儿科患者中。早期使用PE和CRRT似乎是良好的耐受性，并且没有观察到严重的副作用和早期死亡。在PE和CRRT程序后，细胞因子水平降至正常值，除了可溶性白细胞介素2受体，并且eBV DNA，血清铁蛋白，天冬氨酸转氨酶，总胆红素，总胆汁酸，乳酸脱氢酶和体温值的显着减少，并且增加在中性粒细胞计数中，除了血红蛋白，白蛋白和胆碱酯酶值之外。此外，通过连续的HLH-2004治疗方案，表现出EBV DNA水平的较低检测限，并将所有其他观察指标水平恢复正常。最后，7名患者实现并保持了15至24个月的完全缓解，最终达到了2019年8月。因此，我们的建议是，对患有较严重的EBV-HLH患者的患者可能是一种安全有效的患者的建议。

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    Huang Pei; Huang Chengshuang; Xu Hongbo; Lu Jian; Tian Runmei; Wang Zhao; Chen Yan;

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    Zunyi Med Univ Dept Pediat 2 Affiliated Hosp 149 Dalian Rd Zunyi 563000 Guizhou Peoples R;

    Zunyi Med Univ Dept Pediat 2 Affiliated Hosp 149 Dalian Rd Zunyi 563000 Guizhou Peoples R;

    Zunyi Med Univ Dept Pediat 2 Affiliated Hosp 149 Dalian Rd Zunyi 563000 Guizhou Peoples R;

    Zunyi Med Univ Dept Pediat 2 Affiliated Hosp 149 Dalian Rd Zunyi 563000 Guizhou Peoples R;

    Zunyi Med Univ Dept Pediat 2 Affiliated Hosp 149 Dalian Rd Zunyi 563000 Guizhou Peoples R;

    Capital Med Univ Dept Hematol Beijing Friendship Hosp Beijing Peoples R China;

    Zunyi Med Univ Dept Pediat 2 Affiliated Hosp 149 Dalian Rd Zunyi 563000 Guizhou Peoples R;

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  • 正文语种 eng
  • 中图分类 儿科学;
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