摘要
目的探讨儿童异基因造血干细胞移植术后EB病毒相关淋巴组织增殖性疾病的临床特征及诊治效果。方法收集2016年1月~2019年3月深圳市儿童医院13例发生EB病毒相关淋巴组织增殖性疾病的患者资料,对该13例患者临床特征、诊断以及治疗效果进行分析。结果13例移植后淋巴组织增殖性疾病患者均为EB病毒引发,临床表现主要有淋巴结肿大(92.3%)、发热(76.9%)、鼻塞(53.8%)。有12例患者接受美罗华联合治疗,1例接受单独化疗方案治疗。其中8例患者完全缓解,3例部分缓解,2例死亡,疾病缓解率为84.6%(11/13),死亡率为15.4%(2/13)。结论淋巴组织增殖性疾病与EB病毒活化有密切关系,患者常表现出淋巴结肿大、发热、鼻塞等,临床应当结合患者临床表现及EB病毒DNA载量变化结果对淋巴组织增殖性疾病进行有效诊断,并在早期使用美罗华联合化疗以提高临床疗效。
Objective To investigate the clinical characteristics and treatment effect of Epstein-Barr virus associated post-transplant lymphoproliferative disorder(EBV-PTLD)after allogeneic hematopoietic stem cell transplantation(Allo-HSCT)in children.Methods The data of 13 patients with EBV-PTLD treated in our hospital from January 2016 to March 2019 were collected,and the clinical characteristics,diagnosis and treatment effects of the 13 patients were analyzed.Results 13 PTLD patients were all caused by EBV.The clinical manifestations were mainly lymphadenopathy(92.3%),fever(76.9%),and nasal congestion(53.8%).12 patients received combination therapy with rituximab,and one received chemotherapy alone.Among them,8 patients had complete remission,3 had partial remission,and 2 died.The disease remission rate was 84.6%(11/13)and the mortality rate was 15.4%(2/13).Conclusion Lymphoproliferative disorder are closely related to the activation of EBV.Lymphadenopathy,fever,nasal congestion,etc are the main symptoms.In clinical practice,the clinical manifestations of patients and the results of changes in EBV deoxyribonucleic acid(DNA)load should be used to effectively diagnose lymphoproliferative disorder.In the early stage,the combination therapy with rituximab should be used to improve the clinical efficacy.
作者
王春静
王晓东
张小玲
杨春兰
余阅
张倩
刘四喜
WANG Chunjing;WANG Xiaodong;ZHANG Xiaoling;YANG Chunlan;YU Yue;ZHANG Qian;LIU Sixi(Department of Hematology and Oncology,Shenzhen Children's Hospital,Guangdong,Shenzhen 518017,China)
出处
《中国医药科学》
2020年第12期212-215,共4页
China Medicine And Pharmacy
基金
广东省深圳市卫生计生系统科研项目(201606032)。
关键词
异基因造血干细胞移植
EB病毒
淋巴组织增殖性疾病
美罗华
Allogeneic hematopoietic stem cell transplantation
EB virus
Lymphoproliferative disorder
Rituximab
