Clinical Analysis Of Cytomegalovirus Infection After Sibling Allogeneic Hematopoietic Stem Cell Transplantation For Acute Leukemia

Objective:Of this study was to explore the risk factors and the therapeutic effects of the cytomegalovirus(CMV)infection within 100 days after sibling allogeneic hematopoietic stem cell transplantation in acute leukemia.METHODS:We conducted a retrospective analysis on the CMV infection status and its therapeutic effects of 94 patients of acute leukemia after recevived sibling-identical allogenic hematopoietic stem cell transplantation within 100days in Stem Cell Transplantation Ward of the First Affiliated Hospital of Guangxi Medical University between July 2012 and March 2017.The factors including gender,age,day of granulocyte implantation,type of disease,donor gender and blood group matching,whether ATG was used,whether acute GVHD occurred,disease status at transplantation,HLA-matched conditions were enrolled this study.RESULTS:A total number of 94 patients were enrolled,including 50 male patients and 44 female patients,58 AML patients and 36 ALL patients,and median age of transplantation was 34 years(14-59 years).Twenty-nine patients(30.85%)had CMV infection within 100 days after transplantation,including 28CMV viremia patiens and 1 CMV disease(CMV enteritis)patients.The incidence of CMV disease was 1.06%(1/94).The median of initial infection time was 41 days(12-89 days).The median viral load was 6.8 x 10~3 copies/ml(1.2 x 10~3-1.1 x 10~6 copies/ml).Univariate analysis results showed that the incidence of CMV infection was 47.82%and 25.35%in the ATG group(n=23)and non-ATG group(n=71)respectively,P=0.015.Twenty-two infection patients received ganciclovir or foscarnet combianed with IVIG treatment,and20 patients were cured.The cure rate was 90.91%.Among them,16 infection patients were treated with ganciclovir and IVIG,and 12 patients were cured.Two patients occurred therapy-ralated neutropenia.The cure rate was85.71%.Two of the unhealed patients died of relapse of leukemia and severe pneumonia within six months of transplantation.Six patients received the treatment with foscarnet or IVIG,5 patients were cured,the cure rate was83.33%,1 patient’s creatinine increased and 1 patient recovered after changing treated with ganciclovir.Conclusion:The incidence of CMV infection is higher after acute leukemia sibling allogeneic hematopoietic stem cell transplantation.The use of ATG is a risk factor for CMV infection after sibling allogeneic hematopoietic stem cell transplantation.The use of ganciclovir or foscarnet combined with gamma globulin in the treatment of CMV infection is effective.