Lymphoproliferative disorders involving Epstein-Barr virus after hemopoietic stem cell transplantation.
Lymphoproliferative disorders involving Epstein-Barr virus after hemopoietic stem cell transplantation.
复制标题
造血干细胞移植后涉及 Epstein-Barr 病毒的淋巴细胞增殖性疾病。
DOI：
10.1097/00001622-199903000-00004
复制
发表时间：
1999
影响因子：
3.4
通讯作者：
Heslop,HE
中科院分区：
文献类型：
--
作者：
Aguilar,LK;Rooney,CM;Heslop,HE
淋巴增殖性疾病包括感染EB病毒(EBV)的供者来源的B细胞的不受控制的扩张，是造血干细胞移植后的一个重要问题。T细胞耗尽、主要组织相容性复合体错配和免疫抑制强度等危险因素说明了T细胞免疫监测的重要性。最近的研究已经确定了影响T细胞对EBV反应的病毒和宿主因素。通过聚合酶链式反应监测血液中的EBV载量，可以及早识别高危患者，并及早制定治疗方案。使用供体T细胞的过继免疫治疗方法已被证明有效，EBV特异性细胞毒性T淋巴细胞也已成功地用于预防。然而，防止EBV淋巴增殖的最简单方法可能是在输注前从捐赠者的骨髓中清除B细胞，以防止EBV感染的B细胞的传播。
Lymphoproliferative disorders involving uncontrolled expansion of donor-derived B cells infected with Epstein-Barr virus (EBV) are a significant problem after hemopoietic stem cell transplantation. Risk factors, which include T cell depletion, major histocompatibility complex mismatch, and intensity of immunosuppression illustrate the importance of T cell immune surveillance. Recent studies have identified viral and host factors that affect the T-cell response to EBV. Monitoring EBV load in the blood by polymerase chain reaction allows early identification of high-risk patients and early institution of therapy. Adoptive immunotherapy approaches using donor T cells have proven effective and EBV-specific cytotoxic T lymphocytes have also been used successfully for prophylaxis. The simplest way of preventing EBV lymphoproliferation, however, may be to deplete B cells from the donor marrow prior to infusion to prevent the transmission of EBV-infected B cells.