[异体干细胞移植后人类 parvovirus B19 感染的临床特征]。

J Zhang, R Ma, X Y Luo, X H Zhang, L P Xu, Y Wang, X D Mo, M Lyu, K Y Liu, X J Huang, Y Q Sun
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摘要

人类副病毒B19(HPVB19)属于副病毒科(Parvoviridae)红细胞病毒属,与人类多种疾病相关,HPVB19感染是异基因造血干细胞移植(allo-HSCT)后导致难治性贫血的重要原因之一。本研究回顾性分析了24例造血干细胞移植合并HPVB19感染的患者,整理并总结了allo-HSCT后合并HPVB19感染患者的临床表现、治疗和转归情况,为allo-HSCT后HPVB19感染的处理提供经验。HPVB19感染患者的中位年龄为25岁,感染发生的中位时间为移植后+107天,22人(91.7%)有贫血,中位血红蛋白(HGB)水平为77.5(46-149)克/升,13人(54.2%)有新发贫血或HGB持续下降。住院时间中位数为 19 天。在新发贫血或 HGB 持续下降的患者中,经静脉注射免疫球蛋白和/或抗病毒治疗后,HGB 的平均增幅为 15.69 g/L,10 例(76.92%)患者的治疗有效。HPVB19感染应警惕造血干细胞移植后出现难治性贫血;尽管缺乏特异性治疗,但HPVB19感染患者的总体预后良好。
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[Clinical characteristics of human parvovirus B19 infection after allogeneic stem cell transplantation].

Human parvovirus B19 (HPVB19) belongs to Parvoviridae, a genus of erythrovirus, and has been associated with various human diseases, and HPVB19 infection is one of the most important causes of refractory anemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study retrospectively analyzed 24 patients with HSCT combined with HPVB19 infection to collate and summarize the clinical presentation, treatment, and regression of patients with combined HPVB19 infection after allo-HSCT and provide experience in the management of HPVB19 infection after allo-HSCT. The median age of the patients with HPVB19 infection was 25 years, and the median time of infection occurrence was +107 days after transplantation, and 22 (91.7% ) had anemia with a median hemoglobin (HGB) level of 77.5 (46-149) g/L, and 13 (54.2% ) had new-onset anemia or persistent decline in HGB. The median length of hospital stay was 19 days. Among patients with new-onset anemia or persistent decline in HGB, the mean increase in HGB after treatment with intravenous immunoglobulin and/or antiviral therapy was 15.69 g/L, and treatment was effective in 10 (76.92% ) patients. HPVB19 infection should be alerted to the development of refractory anemia after HSCT; despite the lack of specific treatment, the overall prognosis of HPVB19-infected patients is good.

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