缬更昔洛韦抢先治疗异基因造血干细胞移植后巨细胞病毒血症的临床研究

陆铉; 严晗; 夏凌辉

doi:10.16016/j.1000-5404.202005126

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缬更昔洛韦抢先治疗异基因造血干细胞移植后巨细胞病毒血症的临床研究

更新时间：2026-01-09

- 缬更昔洛韦抢先治疗异基因造血干细胞移植后巨细胞病毒血症的临床研究
- Valganciclovir for cytomegalovirus preemptive therapy in patients following allogeneic hematopoietic stem cell transplantation
- 第三军医大学学报 2020年42卷第17期页码：1706-1711
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家自然科学基金青年科学基金(81500109)
- DOI：10.16016/j.1000-5404.202005126
  中图分类号：
- 收稿：2020-05-17，
  
  纸质出版：2020-09-15
- 稿件说明：
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陆铉, 严晗, 夏凌辉. 缬更昔洛韦抢先治疗异基因造血干细胞移植后巨细胞病毒血症的临床研究[J]. 第三军医大学学报, 2020,42(17):1706-1711.

Xuan LU, Han YAN, Linghui XIA. Valganciclovir for cytomegalovirus preemptive therapy in patients following allogeneic hematopoietic stem cell transplantation[J]. Journal of Third Military Medical University, 2020, 42(17): 1706-1711.
陆铉, 严晗, 夏凌辉. 缬更昔洛韦抢先治疗异基因造血干细胞移植后巨细胞病毒血症的临床研究[J]. 第三军医大学学报, 2020,42(17):1706-1711. DOI： 10.16016/j.1000-5404.202005126.

Xuan LU, Han YAN, Linghui XIA. Valganciclovir for cytomegalovirus preemptive therapy in patients following allogeneic hematopoietic stem cell transplantation[J]. Journal of Third Military Medical University, 2020, 42(17): 1706-1711. DOI： 10.16016/j.1000-5404.202005126.

摘要

Abstract

Objective

and;To evaluate the clinical value of valganciclovir in preemptive treatment of cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) by comparing the efficacy of the drug with other conventional antiviral drugs (ganciclovir or foscarnet sodium).

Methods

and;Clinical data of 139 patients who received allo-HSCT in our institute from December 2017 to April 2019 were collected and retrospectively analyzed. According to conditioning regimen and graft versus host disease (GVHD) prophylactic regimen on dosage of antithymocyte globulin (ATG)

the patients were divided to ATG-free group (

=28)

and low- (≤6 mg/kg

=73) and high-dose ATG groups (

6 mg/kg

=38). Real-time quantitative polymerase chain reaction (RQ-PCR) was performed to detect the peripheral blood level of CMV-DNA after transplantation. For the patients having CMV viremia (CMV-DNA

400 copies/mL)

valganciclovir and ganciclovir or foscarnet sodium were employed for preemptive treatment. The incidence of CMV viremia

and clearance rate and median time of plasma CMV-DNA were compared among the different dose ATG group and conventional drug group.

Results

and;CMV viremia was observed in 52 patients

with

an incidence of 37.4% (52/139). Within 100 d after transplantation

the incidence of CMV viremia was 14.3%

34.2% and 50.0%

respectively

in the ATG-free group

low- and high-dose ATG groups (

=0.011). Among these 52 patients

the clearance rate of plasmic CMV-DNA was 100% in both valganciclovir group (

=20) and conventional antiviral group (

=32). However

the median time of CMV-DNA clearance was significantly shorter in the valganciclovir group than the conventional antiviral group (21

31 d

=0.022). In the high-dose ATG group

the median time of clearance of plasma CMV-DNA was significantly shorter in the valganciclovir group (6 cases) than the conventional antiviral group (13 cases)(7

35 d

andlt;0.001).

Conclusion

and;Preemptive treatment with valganciclovir can effectively shorten the time and accelerate the clearance of plasma CMV-DNA in patients after allo-HSCT

especially in those patients receiving high-dose ATG before transplantation.

关键词

Keywords

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