Cytomegalovirus reactivation in patients with multiple myeloma
Cytomegalovirus reactivation in patients with multiple myeloma
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DOI：
10.1111/ejh.12551
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发表时间：
2016-01-01
影响因子：
3.1
通讯作者：
Nakazato, Tomonori
中科院分区：
文献类型：
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作者：
Hasegawa, Tetsuo;Aisa, Yoshinobu;Nakazato, Tomonori
新型抗骨髓瘤药物的引入显著改善了多发性骨髓瘤（MM）的预后。然而，它也导致疱疹病毒科病毒感染的发生率增加，包括移植后用新型药物治疗后巨细胞病毒（CMV）再激活的高发生率。我们在此回顾性评估了在我院连续就诊和治疗的120例新诊断的MM患者的巨细胞病毒再激活情况。根据临床情况，对58例患者进行了CMV抗原血症检测，CMV再激活和证实/疑似CMV疾病需要抗病毒治疗的发生率分别为20%（120例中的24例）和11%（120例中的13例），包括未进行干细胞移植（SCT）的患者。将这些患者的临床和实验室特征与34例CMV抗原阴性（CMV阴性）患者的临床和实验室特征进行比较。髓外疾病或低绝对淋巴细胞计数（ALC）的患者发生巨细胞病毒再激活的风险较高。此外，从MM诊断到CMV再激活的中位持续时间为5.0个月。这些结果表明，无论是否接受SCT，接受新型药物治疗的老年MM患者都应监测CMV再激活情况，以便及时诊断和治疗，特别是对于那些患有髓外疾病的患者。
The introduction of novel antimyeloma agents has improved the outcome of multiple myeloma (MM) dramatically. However, it has also led to an increasing incidence of Herpesviridae family virus infections, including a high incidence of post-transplant cytomegalovirus (CMV) reactivation after treatment with novel agents. We herein retrospectively assessed the CMV reactivation in all 120 newly diagnosed patients with MM consecutively seen and treated at our hospital. CMV antigenemia tests were ordered in 58 patients depending on the clinical context, and the incidence of CMV reactivation and proven/suspected CMV disease requiring antiviral therapy was 20% (24 of 120) and 11% (13 of 120) respectively, including those without stem cell transplantation (SCT). The clinical and laboratory characteristics of these patients were compared with those in 34 CMV antigenemia-negative (CMV-negative) patients. Patients with extramedullary disease or a low absolute lymphocyte count (ALC) had a higher risk of developing CMV reactivation. In addition, the median duration from the time of MM diagnosis to CMV reactivation was 5.0 months. These results suggest that, regardless of whether or not undergoing SCT, elderly patients with MM receiving novel agents should be monitored for CMV reactivation to allow for the timely diagnosis and treatment, especially for those with extramedullary disease.