Cord-blood hematopoietic stem cell transplant confers an increased risk for human herpesvirus-6-associated acute limbic encephalitis: a cohort analysis.
Cord-blood hematopoietic stem cell transplant confers an increased risk for human herpesvirus-6-associated acute limbic encephalitis: a cohort analysis.
复制标题
DOI：
10.1016/j.bbmt.2012.04.016
复制
发表时间：
2012-11
影响因子：
4.3
通讯作者：
Marty, Francisco M.
中科院分区：
文献类型：
--
作者：
Hill, Joshua A.;Koo, Sophia;Suarez, Belisa B. Guzman;Ho, Vincent T.;Cutler, Corey;Koreth, John;Armand, Philippe;Alyea, Edwin P., III;Baden, Lindsey R.;Antin, Joseph H.;Soiffer, Robert J.;Marty, Francisco M.
人类疱疹病毒-6（HHV-6）在异基因造血干细胞移植（HSCT）后经常重新激活;其最严重的表现是移植后急性边缘系统脑炎（HHV-6-PALE）综合征。无关脐带血移植（UCBT）后HHV-6-PALE的流行病学、危险因素和特征尚未得到很好的表征。我们分析了2003年3月至2010年3月期间接受同种异体HSCT的1，344例患者，以确定HHV-6-PALE的风险因素和特征。该队列包括1，243名成人供体HSCT和101名UCBT接受者。所有诊断为HHV-6-PALE的患者除了症状和研究表明边缘系统脑炎外，CSF标本中还含有HHV-6 DNA。本研究期间确定了19例（1.4%）HHV 6-PALE病例; UCBT后10例（9.9%）和成人供体HSCT后9例（0.7%），发生率分别为1.2例/1000患者-天和0.08例/1000患者-天（p<0.001）。多变量考克斯模型中HHV-6-PALE的风险因素为UCBT（校正的风险比（aHR）20.0; 95%置信区间（CI），7.3-55.0; p<0.001），时间依赖性急性移植物抗宿主病II-IV级（aHR 7.5; 95%CI，2.8-19.8; p<0.001）和成人不匹配供体（aHR 4.3; 95%CI，1.1-17.3; p=0.04）。在接受UCBT的受影响患者中，50%的人死于HHV-6-PALE，没有成人供体细胞的接受者。接受UCBT的患者患HHV 6-PALE的风险增加，这种疾病的发病率更高。
Human herpesvirus-6 (HHV-6) frequently reactivates after allogeneic hematopoietic stem-cell transplantation (HSCT); its most severe manifestation is the syndrome of post-transplantation acute limbic encephalitis (HHV-6-PALE). The epidemiology, risk factors, and characteristics of HHV-6-PALE after unrelated cord-blood transplantation (UCBT) are not well characterized. We analyzed 1,344 patients undergoing allogeneic HSCT between March 2003 and March 2010 to identify risk factors and characteristics of HHV-6-PALE. The cohort included 1,243 adult-donor HSCT and 101 UCBT recipients. All patients diagnosed with HHV-6-PALE had HHV-6 DNA in CSF specimens in addition to symptoms and studies indicating limbic encephalitis. 19 (1.4%) cases of HHV6-PALE were identified during this study; 10 after UCBT (9.9%) and 9 after adult-donor HSCT (0.7%), for an incidence rate of 1.2 cases/1000 patient-days compared to 0.08 cases/1000 patient-days (p<0.001), respectively. Risk factors for HHV-6-PALE on multivariable Cox modeling were UCBT (adjusted hazard ratio (aHR) 20.0; 95% confidence interval (CI), 7.3–55.0; p<0.001), time-dependent acute graft-versus-host disease grades II-IV (aHR 7.5; 95% CI, 2.8–19.8; p<0.001), and adult-mismatched donor (aHR 4.3; 95% CI, 1.1–17.3; p=0.04). Death from HHV-6-PALE occurred in 50% of affected patients undergoing UCBT and no recipients of adult-donor cells. Patients receiving UCBT have increased risk for HHV6-PALE and greater morbidity from this disease.
登录
查看更多内容
影响因子：
20.3
作者：
Antin, JH;Kim, HT;Soiffer, RJ
通讯作者：
Soiffer, RJ
影响因子：
4.8
作者：
Cutler C;Stevenson K;Kim HT;Brown J;McDonough S;Herrera M;Reynolds C;Liney D;Kao G;Ho V;Armand P;Koreth J;Alyea E;Dey BR;Attar E;Spitzer T;Boussiotis VA;Ritz J;Soiffer R;Antin JH;Ballen K
通讯作者：
Ballen K
影响因子：
20.3
作者：
Alyea, EP;Kim, HT;Soiffer, RJ
通讯作者：
Soiffer, RJ
影响因子：
6.4
作者：
KIKUTA, H;LU, H;MATSUMOTO, S
通讯作者：
MATSUMOTO, S
影响因子：
6.4
作者：
BURNS, WH;SANDFORD, GR
通讯作者：
SANDFORD, GR