Cytomegalovirus gastroenteritis in patients with acute graft-versus-host disease.
Cytomegalovirus gastroenteritis in patients with acute graft-versus-host disease.
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DOI：
10.1182/bloodadvances.2021005885
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发表时间：
2022-01-25
期刊：
影响因子：
7.5
通讯作者：
Nakasone H
中科院分区：
文献类型：
--
作者：
Akahoshi Y;Kimura SI;Tada Y;Matsukawa T;Tamaki M;Doki N;Uchida N;Tanaka M;Nakamae H;Kuriyama T;Matsuoka KI;Ikeda T;Kimura T;Fukuda T;Kanda Y;Atsuta Y;Murata M;Terakura S;Nakasone H
由于 NRM 风险较高，急性 GVHD 后的 CMV 胃肠炎与总生存期较差相关。莱特莫韦显着降低 G24GVHD 患者发生 CMV 胃肠炎和 NRM 的风险。先发制人的策略已成功减少同种异体造血细胞移植（HCT）后的巨细胞病毒（CMV）疾病。然而，一些受者仍然会出现巨细胞病毒胃肠炎，特别是在急性移植物抗宿主病（aGVHD）后，其发病率、危险因素和预后影响仍有待阐明。我们使用日本注册数据库回顾性分析了 3759 名发生 II-IV 级 aGVHD 的连续成年患者。从发展为 II-IV 级 aGVHD 到第 365 天，CMV 胃肠炎的累积发病率为 5.7%。高龄（风险比 [HR]，1.60；95% 置信区间 [CI]，1.16-2.22；P = .004），用吗替麦考酚酯和钙调神经磷酸酶抑制剂预防 GVHD（HR，1.73；95% CI，1.08-2.77；P = .024），下肠 aGVHD（HR， 2.17；95% CI，1.58-2.98；P < .001）和全身类固醇的使用（HR，1.78；95% CI，1.16-2.74；P = .008）是 CMV 胃肠炎的独立危险因素。 CMV 胃肠炎的发生与非复发死亡率风险增加相关（HR，1.89；95% CI，1.50-2.39；P < .001）。此外，莱特莫韦预防显着降低了 CMV 胃肠炎的发生率（HR，0.50；95% CI，0.25-0.99；P = .047）和非复发死亡风险（HR，0.72；95% CI，0.52-0.99；P = .043）。总之，巨细胞病毒胃肠炎是一种危及生命的并发症，需要采用莱特莫韦和有针对性的监测进行预防策略。
CMV gastroenteritis after acute GVHD is associated with an inferior overall survival because of a higher risk of NRM. Letermovir significantly reduces the risk of CMV gastroenteritis and NRM in patients with G24GVHD. A preemptive strategy has successfully decreased cytomegalovirus (CMV) disease after allogeneic hematopoietic cell transplantation (HCT). However, some recipients still develop CMV gastroenteritis, especially after acute graft-versus-host disease (aGVHD), and its incidence, risk factors, and prognostic impact remain to be elucidated. We retrospectively analyzed 3759 consecutive adult patients who developed grade II-IV aGVHD using a Japanese registry database. The cumulative incidence of CMV gastroenteritis was 5.7% by day 365 from the development of grade II-IV aGVHD. Advanced age (hazard ratio [HR], 1.60; 95% confidence interval [CI], 1.16-2.22; P = .004), GVHD prophylaxis with mycophenolate mofetil and calcineurin inhibitor (HR, 1.73; 95% CI, 1.08-2.77; P = .024), lower-gut aGVHD (HR, 2.17; 95% CI, 1.58-2.98; P < .001), and the use of systemic steroids (HR, 1.78; 95% CI, 1.16-2.74; P = .008) were independent risk factors for CMV gastroenteritis. Development of CMV gastroenteritis was associated with an increased risk of nonrelapse mortality (HR, 1.89; 95% CI, 1.50-2.39; P < .001). Moreover, letermovir prophylaxis significantly reduced both the incidence of CMV gastroenteritis (HR, 0.50; 95% CI, 0.25-0.99; P = .047) and the risk of nonrelapse mortality (HR, 0.72; 95% CI, 0.52-0.99; P = .043). In summary, CMV gastroenteritis is a life-threatening complication that sets the need for preventive strategies with letermovir and targeted surveillance.
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影响因子：
4.3
作者：
Green, Margaret L.;Leisenring, Wendy;Stachel, Daniel;Pergam, Steven A.;Sandmaier, Brenda M.;Wald, Anna;Corey, Lawrence;Boeckh, Michael
通讯作者：
Boeckh, Michael
DOI：
10.1016/j.bbmt.2008.12.497
发表时间：
2009-03
期刊：
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
影响因子：
--
作者：
Giralt S;Ballen K;Rizzo D;Bacigalupo A;Horowitz M;Pasquini M;Sandmaier B
通讯作者：
Sandmaier B
对医疗统计信息的自由使用的易于使用的软件“ EZR”的调查。
影响因子：
4.8
作者：
Kanda Y
通讯作者：
Kanda Y
影响因子：
4.3
作者：
Bhutani, Divaya;Dyson, Gregory;Manasa, Richard;Deol, Abhinav;Ratanatharathorn, Voravit;Ayash, Lois;Abidi, Muneer;Lum, Lawrence G.;Al-Kadhimi, Zaid;Uberti, Joseph P.
通讯作者：
Uberti, Joseph P.
影响因子：
20.3
作者：
Armand, Philippe;Kim, Haesook T.;Saber, Wael
通讯作者：
Saber, Wael