Low incidence of HHV‐6 reactivation in haploidentical hematopoietic stem cell transplantation with corticosteroid as graft‐vs‐host disease prophylaxis compared with cord blood transplantation
Low incidence of HHV‐6 reactivation in haploidentical hematopoietic stem cell transplantation with corticosteroid as graft‐vs‐host disease prophylaxis compared with cord blood transplantation
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与脐带血移植相比，使用皮质类固醇作为移植物抗宿主病预防的半相合造血干细胞移植中 HHV-6 再激活的发生率较低
DOI：
10.1111/tid.13073
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发表时间：
2019
影响因子：
2.6
通讯作者：
Ogawa Hiroyasu
中科院分区：
文献类型：
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作者：
Tamaki Hiroya;Ikegame Kazuhiro;Yoshihara Satoshi;Kaida Katsuji;Yoshihara Kyoko;Inoue Takayuki;Kato Ruri;Nakata Jun;Fujioka Tatsuya;Soma Toshihiro;Okada Masaya;Ogawa Hiroyasu
背景人类白细胞抗原（HLA）错配和免疫抑制剂的使用被认为是干细胞移植（SCT）后人类疱疹病毒6型（HHV-6）再激活的风险。然而，HHV-6再激活的发生率在HLA-不匹配的相关SCT仍然未知。方法我们监测血浆HHV-6 DNA载量每周使用真实的实时定量聚合酶链反应5周后SCT和比较血清IL-6水平在HLA-不匹配SCT groups.ResultsCompared检测在所有11个脐带血移植（CBT）患者（100%），尽管分别使用甲基强的松龙和抗胸腺细胞球蛋白作为移植物抗宿主病预防和降低强度预处理方案，但仅在42例单倍SCT患者中的3例（7.1%）中检测到血浆HHV-6 DNA。相应地，haplo-SCT患者的血清IL-6水平显著低于CBT患者。两组均未发生HHV-6相关性脑炎。结论HLA差异和甲基强的松龙及抗胸腺细胞球蛋白的使用均不是HHV-6再激活的危险因素。而不是增加风险，免疫抑制剂的管理可能防止HHV-6再激活后haplo-SCT通过抑制IL-6的生产。
BackgroundHuman leukocyte antigen (HLA) mismatch and the administration of immunosuppressive agents are considered risks for human herpesvirus 6 (HHV‐6) reactivation after stem cell transplantation (SCT). However, the incidence of HHV‐6 reactivation in HLA‐mismatched related SCT remains unknown.MethodsWe monitored plasma HHV‐6 DNA loads weekly using real‐time quantitative polymerase chain reaction for 5 weeks after SCT and compared serum IL‐6 levels in HLA‐mismatched SCT groups.ResultsCompared with detection in all 11 umbilical cord blood transplantation (CBT) patients (100%), plasma HHV‐6 DNA was detected in only 3 of 42 haplo‐SCT patients (7.1%) despite the use of methylprednisolone and antithymocyte globulin as graft‐vs‐host disease prophylaxis and a reduced‐intensity conditioning regimen, respectively. Correspondingly, serum IL‐6 levels in haplo‐SCT patients were significantly lower than those in CBT patients. No HHV‐6‐associated encephalitis developed in either groups.ConclusionsNeither HLA disparity nor the use of methylprednisolone and antithymocyte globulin were risk factors for HHV‐6 reactivation in our haplo‐SCT patients. Rather than increasing risk, the administration of immunosuppressive agents potentially prevented HHV‐6 reactivation after haplo‐SCT by suppressing IL‐6 production.