清髓性不含抗胸腺细胞球蛋白方案的非血缘脐血移植后免疫重建与巨细胞病毒感染情况分析

摘要

Objective To investigate the incidence of cytomegalovirus infection after unrelated cord blood trans-plantation (UCBT) following myeloablative conditioning without antithymocyte globulin ( ATG). Methods The data of 100 patients, who underwent UCBT, were collected, and the incidences of CMV infection and CMV dis-ease, as well as primary lymphocytes reconstitution were analyzed retrospectly. Results The incidence of plasma CMV-DNA copies > 10 / ml and > 103 / ml in peripheral blood ( PB) of patients after UCBT were 92. 7% and 75. 3% , respectively. The median time of plasma CMV-DNA copies > 103 / ml in PB of patients after UCBT was 42 days. The incidence of CMV disease was 1. 03% . The median time for CMV clearance was 94 days. Lymphocytes counts steadily increased after UCBT and the median count of CD3 + CD8 + T cells and CD3 + CD4 + T cells reached the normal level at month 2 and 5 after UCBT respectively. Conclusion The immune reconstitution of T cell sub-set is relatively fast after UCBT following myeloablative conditioning without ATG and the incidence of CMV viremia is high, but the incidence of CMV disease is low after this UCBT protocal.%目的：探讨清髓性不含抗胸腺细胞球蛋白(ATG)方案的非血缘脐血移植(UCBT)后巨细胞病毒(CMV)感染(血症)的发病情况。方法回顾性分析100例接受清髓性不含ATG 方案的 UCBT 患者移植后 CMV 血症及 CMV 病发生情况,同时初步分析 UCBT 后受者早期淋巴细胞重建情况。结果 UCBT 后受者外周血 CMV 拷贝数>10/ ml 发生率为92．7%,血 CMV 拷贝数>103/ ml 发生率为75．3%；中位发生时间为42 d。 CMV 病发生率为1．03%。 CMV 转阴的中位时间为94 d。 UCBT 后淋巴细胞持续稳定上升,中位CD3+ CD8+ T 细胞及 CD3+ CD4+ T 细胞分别于移植后2个月及5个月达正常范围。结论清髓性不含 ATG 方案的UCBT 后 T 细胞免疫重建相对较快,CMV 血症发生率高,但CMV 病发生率较低。