Cytomegalovirus Viral Load and Virus-Specific Immune Reconstitution after Peripheral Blood Stem Cell versus Bone Marrow Transplantation
Cytomegalovirus Viral Load and Virus-Specific Immune Reconstitution after Peripheral Blood Stem Cell versus Bone Marrow Transplantation
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DOI：
10.1016/j.bbmt.2011.05.010
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发表时间：
2012-01-01
影响因子：
4.3
通讯作者：
Boeckh, Michael
中科院分区：
文献类型：
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作者：
Guerrero, Abraham;Riddell, Stanley R.;Boeckh, Michael
与骨髓(BM)相比，外周血干细胞(PBSC)产品含有更多的T细胞和单核细胞，导致更少的细菌和真菌感染。在一项随机试验中，对巨细胞病毒(CMV)病毒载量和疾病以及CMV特异性免疫重建进行了比较，比较了PSBC移植和骨髓移植。PBSC移植后100天内CMV感染和疾病的发生率较高(任何抗原血症/DNA血症：PBSC，63%vs BM，42%，P=0.04；CMV病：PBSC，17%vs BM，4%，P=.03)。两年后，巨细胞病毒的发病率相似。在移植后30天，PBSC受者早期CMV事件的增加与CMV特异性的CD4(+)T辅助细胞和CD8(+)细胞毒性T淋巴细胞功能降低暂时相关。在移植后3个月及之后，骨髓和外周血干细胞受者之间的CMV特异性免疫反应相似。综上所述，PBSC移植受者在移植后早期发生更高的CMV感染和发病率。这些差异可能是由于PBSC移植后CMV特异性免疫重建的一过性延迟。生物骨髓移植18：66-75(2012)(C)2012美国血液和骨髓移植学会
Peripheral blood stem cell (PBSC) products contain more T cells and monocytes when compared with bone marrow (BM), leading to fewer bacterial and fungal infections. Cytomegelovirus (CMV) viral load and disease as well as CMV-specific immune reconstitution were compared in patients enrolled in a randomized trial comparing PSBC and BM transplantation. There was a higher rate of CMV infection and disease during the first 100 days after transplantation among PBSC recipients (any antigenemia/DNAemia: PBSC, 63% vs BM, 42%, P = .04; CMV disease: PBSC, 17% vs BM, 4%, P = .03). By 2 years, CMV disease rates were similar. The early increase in CMV events correlated temporarily with lower CMV-specific CD4(+) T helper and CD8(+) cytotoxic T lymphocyte function at 30 days after transplantation in PBSC recipients. By 3 months after transplantation and thereafter, CMV-specific immune responses were similar between BM and PBSC recipients. In conclusion, higher CMV infection and disease rates occurred in PBSC transplant recipients early after transplantation. These differences may be because of a transient delay in CMV-specific immune reconstitution following PBSC transplantation. Biol Blood Marrow Transplant 18: 66-75 (2012) (C) 2012 American Society for Blood and Marrow Transplantation