对于HHV-6脑炎在成人单带血移植中使用福斯卡内特的预防作用
Kotaro Suzuki1, Junya Kanda1, Tomoki Iemura1
1Department of Hematology and Oncology, Kyoto University, Kyoto, Japan.
概括
在非相关的带血移植 (UCBT) 后,福斯卡内特预防并没有显著减少人类疹病毒6 (HHV-6) 脑炎. 高剂量类固醇增加了风险,但福斯卡内特可能有利于接受低剂量类固醇的患者.
科学领域:
- 造血干细胞移植 造血干细胞移植
- 病毒学 病毒学
- 传染性疾病 传染性疾病
背景情况:
- 人类疹病毒6 (HHV-6) 脑炎是异质造血干细胞移植后的一种严重并发症.
- 在无关带血移植 (UCBT) 后,特别是在同时使用类固醇时,对HHV-6脑炎的福斯卡内特预防的疗效和安全性尚未得到充分证实.
研究的目的:
- 评估福斯卡内特预防对接受UCBT的成年患者HHV-6脑炎发病率的影响.
- 评估福斯卡内特预防,全身类固醇暴露和患者结局,包括整体存活率和功能之间的关联.
主要方法:
- 在2005年至2022年期间接受单单元UCBT的156名成年患者的回顾性队列研究.
- 福斯卡内特的预防被定义为在脑炎发作之前使用它. 主要终点:60天的HHV-6脑炎发病率. 二级终点:整体存活率和功能长达12个月.
主要成果:
- 在60天内,HHV-6脑炎的发病率为10.9%,基于福斯卡内特整体预防没有显著差异 (9.9%对14.3%).
- 高剂量的皮质类固醇使用与增加的HHV-6脑炎发病率 (28.6%与7.1%) 有显著的关联.
- 在低剂量类固醇小组中,福斯卡内特预防与HHV-6脑炎发病率显著降低 (4.3%与14.7%相比). 在脑炎患者中,先前接触过福斯卡内特的1年生存率更高.
结论:
- 福斯卡内特预防没有显著降低UCBT后的HHV-6脑炎的总体发病率.
- 高剂量的类固醇暴露是HHV-6脑炎的危险因素.
- 在接受低剂量类固醇的患者中,福斯卡内特预防可能会减少HHV-6脑炎的发生率,这需要在更大的研究中进一步调查.
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