异基因造血干细胞移植治疗合并冠状动脉病变儿童慢性活动性EB病毒感染6例报道  

Allogeneic hematopoietic stem cell transplantation for the treatment of chronic active Epstein-Barr virus infection in children with coronary artery lesions:A report of 6 cases retrospective analysis

作　　者：杨骏[1] 赵云泽 朱光华[1] 王彬[1] 贾晨光[1] 张蕊[1] 秦茂权[1] 王天有[1] YANG Jun;ZHAO Yunze;ZHU Guanghua;WANG Bin;JIA Chenguang;ZHANG Rui;QIN Maoquan;WANG Tianyou(Stem Cell Transplantation Department,Hematology Center,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing Key Laboratory of Pediatric Hematology Oncology,National Key Discipline of Pediatrics,Key Laboratory of Major Diseases in Children,Ministry of Education,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院血液病中心,干细胞移植科,儿童血液病与肿瘤分子分型北京市重点实验室,儿科学国家重点学科儿科重大疾病研究教育部重点实验室,北京100045

出　　处：《中国小儿血液与肿瘤杂志》2025年第1期9-14,共6页Journal of China Pediatric Blood and Cancer

摘　　要：目的本研究旨在评价异基因造血干细胞移植(allo-HSCT)治疗儿童慢性活动性EB病毒感染(CAEBV)合并冠状动脉病变(CAL)的可行性及临床疗效。方法对我院2015年6月—2023年12月期间行allo-HSCT的全部CAEBV合并CAL患儿临床资料进行回顾性分析。结果截止到2023年12月底,共有87例CAEBV患儿进行allo-HSCT,有6例合并CAL,总体发生率6.9%,男女比例5∶1,起病到出现CAL平均时间为(2.19±2.11)个月(5d~6个月),除1例接受了同胞全相合的allo-HSCT外,其余5例均为单倍型allo-HSCT,allo-HSCT时平均年龄(4.50±3.56)岁。平均观察时间(43.46±24.08)个月,随访结束时,全部患儿均存活,CAL有不同程度的恢复。其中4例发生急性移植物抗宿主病,4例患儿发生典型血栓性微血管病变。结论CAL为CAEBV患儿少见并发症,及时应用化疗及allo-HSCT可有效控制患儿CAL进展。Objective This study aims to evaluate the feasibility and clinical efficacy of allogeneic hematopoietic stem cell transplantation for the treatment of chronic active Epstein-Barr virus infection(CAEBV)in children with coronary artery lesions.Methods Retrospective analysis was conducted on the clinical data of all CAEBV with coronary artery lesions patients who underwent allogeneic hematopoietic stem cell transplantation at Beijing Children′s Hospital from June 2015 to December 2023.The clinical outcomes of children with coronary artery lesions were compared and comprehensively evaluated accordingly.Results By the end of December 2023,a total of 87 patients with CAEBV had undergone hematopoietic stem cell transplantation.Among them,6 patients had coronary artery lesions,with an overall incidence of 6.9%.The male-to-female ratio was 5∶1,and the average time of the onset to the coronary artery lesions was(2.19±2.11)months(5d~6months).Except for one patient who received sibling fully matched hematopoietic stem cell transplantation,the other five patients received haploidentical transplantation,with an average age of(4.50±3.56)years.The average follow-up time was(43.46±24.08)months.At the end of follow-up,all children were alive and had varying degrees of recovery from coronary artery lesions.Four cases developed acute graft-versus-host disease,4 patients developed typical thrombotic microvascular disease.Conclusions Coronary artery lesions is a rare complication in children with CAEBV.Timely application of chemotherapy and hematopoietic stem cell transplantation can effectively control the progression of coronary artery lesions in children with CAEBV.

关 键 词：慢性活动性EB病毒感染 异基因造血干细胞移植 冠状动脉疾病 

分 类 号：R725.1[医药卫生—儿科]