血造细胞移植后的病毒性脑炎:一个系统性审查
Danny Toomey1, Tuan L Phan2, Thommas Phan3
11Day Sooner Research Team, Delaware; HHV-6 Foundation, Santa Barbara, California.
Transplantation and cellular therapy
|July 8, 2023
概括
病毒性脑炎是血液细胞移植 (HCT) 后的罕见并发症,人类疹病毒6 (HHV-6) 是最常见的原因. 高死亡率凸显出需要改善这种严重疾病的预防和治疗策略.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 神经学 神经学
背景情况:
- 病毒性脑炎是血液细胞移植 (HCT) 后的一种严重,罕见的并发症.
- 早期的症状是不特定的,并且快速进展使及时诊断和治疗复杂化.
- 了解病因和临床过程对于改善患者的治疗结果至关重要.
研究的目的:
- 系统地审查和描述HCT接受者的病毒性脑炎的频率,临床过程,治疗方法和结果.
- 为管理HCT后病毒性脑炎的临床决策提供信息.
主要方法:
- 对涉及HCT受试者进行至少一种病原体测试的研究进行了系统审查.
- 包括的研究描述了感染病毒脑炎的HCT接受者的队列.
- 分析了68篇符合条件的文章的数据,包括72423名患者.
主要成果:
- 病毒性脑炎发生在1.1% (778/72,423) 的HCT接受者中.
- 人类疹病毒6 (HHV-6) 是最常见的病因 (596例),其次是爱斯坦-巴尔病毒 (76例) 和细胞巨型病毒 (33例).
- HHV-6脑炎在移植后100天前最常见,特别是在带血移植 (CBT) 后,总死亡率为37.0%.
结论:
- 病毒性脑炎影响大约1%的HCT接受者,主要原因是HHV-6.
- 在HCT接受者中,与脑炎相关的死亡率很大.
- 对于HCT后的病毒性脑炎有必要加强预防和治疗策略.
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