异基因造血干细胞移植后人细小病毒B19感染24例临床分析  

Clinical characteristics of human parvovirus B19 infection after allogeneic stem cell transplantation

作　　者：张晋 马瑞 罗雪宜 张晓辉[1] 许兰平[1] 王昱[1] 莫晓东 吕萌[1] 刘开彦[1] 黄晓军[1] 孙于谦[1] Zhang Jin;Ma Rui;Luo Xueyi;Zhang Xiaohui;Xu Lanping;Wang Yu;Mo Xiaodong;Lyu Meng;Liu Kaiyan;Huang Xiaojun;Sun Yuqian(Peking University People's Hospital,Peking University Institute of Hematology,National Clinical Research Center for Hematologic Disease,Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation,Beijing 100044,China)

机构地区：[1]北京大学人民医院、北京大学血液病研究所、国家血液系统疾病临床医学研究中心,造血干细胞移植治疗血液病北京市重点实验室,北京100044

出　　处：《中华血液学杂志》2024年第6期591-593,共3页Chinese Journal of Hematology

基　　金：国家自然科学基金(8227010768);科技部重点研发计划(2021YFC2500300)。

摘　　要：人细小病毒B19(HPVB19)属细小病毒科,红细胞病毒属,与多种人类疾病相关,HPVB19感染是异基因造血干细胞移植(allo-HSCT)后难治性贫血的重要原因之一。此项研究对24例HSCT合并HPVB19感染的患者进行了回顾性分析,旨在整理总结allo-HSCT术后合并HPVB19感染患者的临床表现、治疗与转归,为allo-HSCT后HPVB19感染的管理提供经验。HPVB19感染患者中位年龄为25岁,感染发生的中位时间为移植后107 d(+107 d),有22例(91.7%)患者存在贫血,HGB中位数为77.5(46~149)g/L;新发贫血或血红蛋白持续下降的患者有13例(54.2%)。患者的中位住院时长为19 d,在新发贫血或HGB持续下降的患者中,经过静脉丙种球蛋白和(或)抗病毒治疗后HGB平均升高15.69 g/L,10例(76.92%)患者治疗有效。HSCT后出现难治性贫血时应警惕HPVB19感染;尽管缺乏特异性的治疗手段,HPVB19感染患者总体预后较好。Human parvovirus B19(HPVB19)belongs to Parvoviridae,a genus of erythrovirus,and has been associated with various human diseases,and HPVB19 infection is one of the most important causes of refractory anemia after allogeneic hematopoietic stem cell transplantation(allo-HSCT).This study retrospectively analyzed 24 patients with HSCT combined with HPVB19 infection to collate and summarize the clinical presentation,treatment,and regression of patients with combined HPVB19 infection after allo-HSCT and provide experience in the management of HPVB19 infection after allo-HSCT.The median age of the patients with HPVB19 infection was 25 years,and the median time of infection occurrence was+107 days after transplantation,and 22(91.7%)had anemia with a median hemoglobin(HGB)level of 77.5(46-149)g/L,and 13(54.2%)had new-onset anemia or persistent decline in HGB.The median length of hospital stay was 19 days.Among patients with new-onset anemia or persistent decline in HGB,the mean increase in HGB after treatment with intravenous immunoglobulin and/or antiviral therapy was 15.69 g/L,and treatment was effective in 10(76.92%)patients.HPVB19 infection should be alerted to the development of refractory anemia after HSCT;despite the lack of specific treatment,the overall prognosis of HPVB19-infected patients is good.

关 键 词：难治性贫血 静脉丙种球蛋白 细小病毒科 整理总结 异基因造血干细胞移植 人细小病毒B19 抗病毒治疗 临床分析 

分 类 号：R457.7[医药卫生—治疗学]