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异基因骨髓移植合并巨细胞病毒感染的预防与治疗

Prophylaxis and treatment of cytomegalovirus infection in allogeneic bone marrow transplantation

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【作者】 郭乃榄; 陆道培; 刘代红; 许兰萍; 张耀臣; 陈欢; 黄晓军; 任汉云;

【Author】 GUO Nailan, LU Daopei, LIU Daihong, et al. Institute of Hematology, People’s Hospital, Beijing Medical University, Beijing 100044

【机构】 北京医科大学人民医院血液病研究所; 北京医科大学人民医院血液;

【摘要】 目的 评价赛美维(ganciclovir) 在异基因骨髓移植(alloBMT) 合并巨细胞病毒(CMV) 感染中应用的有效性及安全性。方法 观察alloBMT 合并CMV 患者60 例,其中预防组40 例,治疗组20 例。赛美维预防方案为:静滴5 mg/kg ,每12 小时1 次,- 9~- 2 天。alloBMT 后自中性粒细胞≥1.0×109/L及BPC≥30×109/L开始用药,剂量5 mg ·kg - 1 ·d- 1 ,每周用药5 天,直至+ 100 天。治疗方案为:静滴5 mg/kg ,每12 小时1 次,2~3 周,之后按原剂量每周用药5 天,再持续2~3 周。结果 预防性应用赛美维20 例均未发生活动性CMV 感染,而未用赛美维预防对照组20 例中即有5 例发生活动性CMV 感染( P< 0.05) 。用赛美维预防治疗组20 例中显效17 例(占85% )。赛美维的主要不良反应为白细胞及血小板减少,但均为可逆性。结论 赛美维对于alloBMT 合并CMV 感染的预防与治疗的疗效可靠、用药安全,可作为一线用药。

【Abstract】 Objective To assess the efficacy and safety of Cymevene (ganciclovir) in the prophylaxis and treatment of cytomegalovirus (CMV) infection after allogeneic bone marrow transplantation (allo BMT). Methods Sixty patients with leukemia undergoing allo BMT were observed. Cymevene was given prophylactically to 20 patients at a dose of 5 mg/kg twice daily from day -9 to day -2 and restarted when the ANC≥1.0×109/L and BPC≥30×109/L at a daily dose of 5 mg/kg for 5 days every week until day +100. In diagnosed symptomatic CMV infections, the dose of Cymevene was 5mg/kg twice daily for 2~3 weeks followed by 5 mg/kg twice a day for 5 days every week for an additional 2~3 weeks. Results The incidence of active CMV infection was 0 in the prophylaxis treated patients and 25%in the controls (P<0.05). In diagnosed CMV diseases, marked improvement was noted in 17 of 20 patients (85%) treated with Cymevene. The most common adverse events of Cymevene were leukopenia and thrombocytopenia, but were reversible. Conclusion Cymevene is effective and safe for the prophylaxis and treatment of CMV infections after allo BMT.

  • 【文献出处】 中华血液学杂志 ,CHINESE JOURNAL OF HEMATOLOGY , 编辑部邮箱 ,1999年08期
  • 【分类号】R457.7
  • 【被引频次】18
  • 【下载频次】130
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