地中海贫血儿童非亲缘造血干细胞移植后BK病毒相关出血性膀胱炎临床特征分析  

Clinical feature analysis of BK polyomavirus-associated hemorrhagic cystitis after unrelated donor allogeneic hematopoietic stem cell transplantation in thalassemia children

作　　者：庄燕红[1] 洪秀理[1] 陈洁 陆婧媛[1] 鹿全意[1] ZHUANG Yan-hong;HONG Xiu-li;CHEN Jie(Department of Hematology,Zhongshan Hospital Affiliated to Xiamen University,Fujian 361004,China)

机构地区：[1]厦门大学附属中山医院血液科,福建361004

出　　处：《中国临床新医学》2023年第11期1121-1124,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：厦门市医疗卫生指导性项目(编号:3502Z20199174,3502Z20209024);福建省科技项目(编号:2019D009)。

摘　　要：目的分析输血依赖型地中海贫血儿童非亲缘造血干细胞移植后BK病毒(BKV)相关出血性膀胱炎的发生率、临床特征和影响因素。方法回顾性分析2018年2月至2021年2月厦门大学附属中山医院62例输血依赖型地中海贫血儿童接受非亲缘造血干细胞移植后的临床资料,包括患儿年龄、人类白细胞抗原(HLA)相合程度、急性移植物抗宿主病(aGVHD)和慢性移植物抗宿主病(cGVHD)的发生以及与BKV感染的关联性。结果14例(22.58%,14/62)发生出血性膀胱炎,尿液中均检出BKV感染,BKV copies最高达107/ml,出血性膀胱炎与BKV感染符合率为100.00%。在预处理方案相同情况下,非亲缘全相合、移植物抗宿主病(GVHD)是发生BKV相关出血性膀胱炎的影响因素。结论BKV感染是输血依赖型地中海贫血儿童非亲缘造血干细胞移植后发生出血性膀胱炎的主要原因,非亲缘全相合、GVHD是发生BKV相关出血性膀胱炎的影响因素。Objective To analyze the incidence,clinical features and influencing factors of BK polyomavirus(BKV)-associated hemorrhagic cystitis after unrelated donor allogeneic hematopoietic stem cell transplantation in children with blood transfusion-dependent thalassemia.Methods The clinical data of 62 children with blood transfusion-dependent thalassemia who received unrelated donor allogeneic hematopoietic stem cell transplantation in Zhongshan Hospital Affiliated to Xiamen University from February 2018 to February 2021 were retrospectively analyzed.These clinical data included age of the children,human leukocyte antigen(HLA)compatibility,presence of acute graft-versus-host disease(aGVHD)and chronic graft-versus-host disease(cGVHD),and the correlation of their presence with BKV infection.Results Among the 62 recipients,14 cases(22.58%,14/62)developed hemorrhagic cystitis,and BKV infections were found in their urine,with BKV copies reaching up to 107/ml,and the coincidence rate between hemorrhagic cystitis and BKV infection was 100.00%.Under the same conditioning regimen,unrelated HLA-match and graft-versus-host disease(GVHD)were influencing factors for developing BKV-associated hemorrhagic cystitis.Conclusion BKV infection is the main cause of hemorrhagic cystitis in children with blood transfusion-dependent thalassemia after unrelated donor allogeneic hematopoietic stem cell transplantation.Unrelated HLA-match and GVHD are influencing factors for developing BKV-associated hemorrhagic cystitis.

关 键 词：儿童 地中海贫血 干细胞移植 出血性膀胱炎 BK病毒 

分 类 号：R556.61[医药卫生—血液循环系统疾病]