Disseminated infection with novel human adenovirus (genotype 79) following allogeneic hematopoietic stem cell transplantation
Disseminated infection with novel human adenovirus (genotype 79) following allogeneic hematopoietic stem cell transplantation
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异基因造血干细胞移植后新型人腺病毒（基因型79）播散性感染
DOI：
10.1007/s00277-020-04151-x
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发表时间：
2020
影响因子：
3.5
通讯作者：
Takenaka Katsuto
中科院分区：
文献类型：
--
作者：
Ikeda Yuichi;Tanimoto Kazushi;Azuma Taichi;Fujiwara Hiroshi;Ochi Toshiki;Asai Hiroaki;Nabe Shogo;Maruta Masaki;Takeuchi Kazuto;Yamanouchi Jun;Kitazawa Sohei;Takenaka Katsuto
亲爱的编辑，在高度免疫受损的异基因造血干细胞移植(allo-SCT)后，人类肥大病毒(HAdvs)感染大多通过腺病毒重新激活发生。腺病毒激活引起的症状被认为是异基因干细胞移植后的严重并发症[1]。根据最近的报道，在日本的污水中发现了一种被归类为B2的新型腺病毒“HAdV-79”[2]。在本文中，我们报告了一例异基因骨髓移植后致死性HAdV-79感染的患者，患者为67岁的女性，患有与治疗相关的骨髓增生异常综合征。经过两个疗程的阿糖胞苷、阿克拉阿霉素和G-CSF治疗后，患者的病情完全缓解。异基因骨髓移植来自经氟达拉滨、马法兰和全身放射治疗前的人类白细胞抗原和血型匹配、性别不匹配的非血缘关系供者。移植物抗宿主病的预防包括他克莫司和霉酚酸酯。第14天，植入得到确认。在第70天后，全血细胞减少发展并逐渐进展，在第89天，患者被诊断为继发性植入失败。在第94天，呼吸衰竭迅速发展，肾功能障碍进一步恶化。患者被诊断为重症肺炎和双侧肾脏。
Dear Editor, Human mastadenoviruses (HAdVs) infections following allogeneic hematopoietic stem cell transplantation (allo-SCT) in a highly immunocompromised state mostly occur through adenovirus reactivation. Symptoms caused by adenovirus reactivation are regarded as serious complications following allo-SCT [1]. As recently reported,“HAdV-79,” a novel adenovirus classified as B2, is found in sewage in Japan [2]. In the present article, we report a case of lethal HAdV-79 infection in a patient following allogeneic bone marrow transplantationThe patient was a 67-year-old female with treatmentrelated myelodysplastic syndrome. Complete remission was achieved following two courses of treatment with cytarabine, aclarubicin, and G-CSF. Allogenic bone marrow transplantation was conducted from HLA-and blood type-matched, sexunmatched unrelated donors pretreated with fludarabine, melphalan, and total body irradiation. Graft-versus-host disease prophylaxis consisted of tacrolimus and mycophenolate mofetil. On day 14, engraftment was confirmed. After day 70, pancytopenia developed and gradually progressed, and on day 89, the patient was diagnosed with secondary engraftment failure. On day 94, respiratory failure rapidly progressed, and the renal dysfunction further deteriorated. The patient was diagnosed with severe pneumonia and bilateral renal