血液细胞移植中的传染性肠球炎与移植后的环胺
Pedro Chorão1, André Airosa Pardal2, Santiago de Cossio3
1Hematology Department, Hospital Universitari i Politècnic La Fe, València, Spain; Hematology Research Group, Institut d'Investigació Sanitària La Fe, València, Spain.
Transplantation and cellular therapy
|March 11, 2025
概括
传染性肠球炎影响了大约五分之一的血液细胞移植 (HCT) 患者,并进行了移植后环胺 (PTCy) 预防. 虽然通常在两周内消失,不会影响生存,但诊断可能具有挑战性.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 移植免疫学 移植免疫学
背景情况:
- 输血细胞移植 (HCT) 后腹很常见,通常是由于感染.
- 关于接受移植后环胺 (PTCy) 用于移植对宿主疾病 (GVHD) 预防的患者感染性肠球炎的数据有限.
- 分子诊断技术已经推进了感染病原体的识别.
研究的目的:
- 评估使用PTCy用于GVHD预防的HCT接受者感染性肠球炎的特征,发病率,风险因素和结果.
- 为了比较从匹配的兄弟姐妹,无血缘关系的或单一的捐赠者接收移植的患者的传染性肠球炎.
- 评估传染性肠球炎对移植结果的影响.
主要方法:
- 追溯分析399名接受HCT并接受统一的GVHD预防的患者 (PTCy,西洛利木斯,甲酸莫菲蒂尔).
- 在骨髓细胞移植之前,使用了利沃富洛克萨预防.
- 使用分子技术和便培养物诊断的传染性肠球炎.
主要成果:
- 传染性肠球炎发生在21%的患者中,19%的患者经历了多次发作.
- 常见的原因包括Clostridioides difficile感染 (CDI;7%),非CDI细菌 (8%) 和病毒性肠球炎 (6%),具有类似的临床特征.
- 骨髓HCT和中度至重度的慢性GVHD与风险增加有关;传染性肠球炎没有显著影响生存率或死亡率.
结论:
- 大约五分之一的基于PTCy的HCT接受者患有传染性肠球炎,通常在两周内消失.
- 骨髓接受者和中度至重度慢性GVHD患者的发病率更高.
- 尽管在诊断方面存在挑战,但传染性肠球炎并没有显著影响移植结果.
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