Different Risk Factors Related to Adenovirus- or BK Virus-Associated Hemorrhagic Cystitis following Allogeneic Stem Cell Transplantation
Different Risk Factors Related to Adenovirus- or BK Virus-Associated Hemorrhagic Cystitis following Allogeneic Stem Cell Transplantation
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DOI：
10.1016/j.bbmt.2011.07.025
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发表时间：
2012-03-01
影响因子：
4.3
通讯作者：
Akashi, Koichi
中科院分区：
文献类型：
--
作者：
Mori, Yasuo;Miyamoto, Toshihiro;Akashi, Koichi
病毒相关性出血性膀胱炎(HC)是异基因造血干细胞移植(HSCT)后发病率和死亡率的主要原因。尽管许多研究试图确定患者易患病毒性肝炎的因素，但其原因仍存在争议。我们回顾分析了266例同种异体造血干细胞移植的结果，以确定与HC相关的因素。在这组患者中，42例(15.8%)被诊断为病毒性肝炎，原因是腺病毒(ADV；n=26；9.8%)或BK病毒(BKV；n=16；6.0%)。ADV-HC常与T细胞净化有关，在急性移植物抗宿主病(GVHD)患者中较少见。相反，BKV-HC更多见于免疫反应过度的患者，如移植物抗宿主病、移植前免疫反应和噬血细胞综合征。这些观察表明，ADV-HC和BKV-HC在危险因素和发病机制上可能有显著不同。严重的免疫缺陷更可能与ADV-HC有关，而免疫亢进可能在BKV-HC中起关键作用。生物骨髓移植18：458-465(2012)(C)2012美国血液和骨髓移植学会
Virus-associated hemorrhagic cystitis (HC) is a major cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation (HSCT). Although numerous studies have attempted to identify factors that predispose patients to viral HC, its causes remain controversial. We analyzed retrospectively the results of 266 allogeneic HSCTs to identify factors associated with HC. Of this group, 42 patients (15.8%) were diagnosed with viral HC, because of either adenovirus (ADV; n = 26; 9.8%) or BK virus (BKV; n = 16; 6.0%). ADV-HC was frequently associated with T cell purging, and was less common in patients with acute graft-versus-host-disease (GVHD). Conversely, BKV-HC was more frequently observed in patients with excessive immune reactions such as GVHD, preengraftment immune reaction, and hemophagocytic syndrome. These observations indicate that ADV- and BKV-HC may differ significantly in their risk factors and pathogenesis. Profound immune deficiency is more likely to be associated with ADV-HC, whereas immune hyperactivity might play a key role in BKV-HC. Biol Blood Marrow Transplant 18: 458-465 (2012) (C) 2012 American Society for Blood and Marrow Transplantation