急性白血病患者合并乙型肝炎病毒感染的研究现状  

Research status of acute leukemia patients with hepatitis B virus infection

作　　者：江兆清 洪鸣[1] Jiang Zhaoqing;Hong Ming(Department of Hematology,First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210029,Jiangsu Province,China)

机构地区：[1]南京医科大学第一附属医院,江苏省人民医院血液科,南京210029

出　　处：《国际输血及血液学杂志》2022年第4期277-283,共7页International Journal of Blood Transfusion and Hematology

基　　金：国家自然科学基金(82170153)。

摘　　要：目前, 对急性白血病(AL)患者主要采取细胞毒性药物化疗、造血干细胞移植治疗为主, 免疫疗法、靶向药物的治疗手段也正在探索中。AL患者易发生乙型肝炎病毒(HBV)感染。合并HBV感染的AL患者依据其血清学状态、HBV DNA水平、疾病亚型及治疗方案的不同, 存在不同级别的HBV再激活(HBVr)风险。HBVr对AL患者的临床疗效及生存预后存在一定影响, 可导致患者的临床结局不同。目前对于AL合并HBV感染患者的研究较少, 对患者综合管理及预防性治疗方法尚无权威指南。笔者拟通过对AL患者的HBV感染率, HBVr发生率及其影响因素, 以及HBVr最佳预防药物、用药时机和疗程选择的研究现状进行阐述, 为AL合并HBV感染患者的临床管理提供参考。Nowadays patients with acute leukemia(AL)are mainly treated with cytotoxic chemotherapy and hematopoietic stem cell transplantation.Immunotherapy and targeted drugs are also being explored.AL patients are prone to hepatitis B virus(HBV)infection.AL patients infecting HBV have different risk grades of HBV reactivation(HBVr)according to their different serological status,HBV DNA level,disease subtypes and treatment regimens.HBVr leads to different clinical consequences which has a certain impact on clinical efficacy and prognosis of patients.Currently few studies have been published on HBVr in patients with AL,and there are no authoritative guidelines for management,prevention and treatment of AL patients infecting HBV.This article provides a reference for clinical management of AL patients with HBV infection through summarizing research status of HBV infection rate,the incidence of HBVr and its influencing factors in AL patients,the selection of the best preventive drug for HBVr,and the timing and course of treatment.

关 键 词：白血病 乙型肝炎病毒 病毒激活 免疫抑制剂 抗病毒药 

分 类 号：R733.71[医药卫生—肿瘤] R512.62[医药卫生—临床医学]