Application of quantitative detection of multiple-source cytomegalovirus DNA in diagnosis of cytomegalovirus pneumonia after allogeneic hematopoietic stem cell transplantation
10.3969/j.issn.1674-7445.2021.01.015
- VernacularTitle:多源化巨细胞病毒DNA定量检测在异基因造血干细胞移植后巨细胞病毒肺炎诊断中的应用
- Author:
Haoyu CHENG
1
;
Fan YANG
;
Yixin YANG
;
Shuqin ZHANG
;
Yongping ZHANG
;
Weijie ZHANG
;
Xinhong FEI
;
Yuming YIN
;
Jiangying GU
;
Jingbo WANG
Author Information
1. Department of Hematology, Aerospace Center Hospital, Beijing 100049, China
- Publication Type:Research Article
- Keywords:
Allogeneic hematopoietic stem cell transplantation;
Cytomegalovirus (CMV);
Pneumonia;
Bronchoalveolar lavage fluid (BALF);
Quantitative detection of DNA;
Graft-versus-host disease;
Ganciclovir;
Foscarnet sodium;
CMV-intravenous immunoglobulin (CMV-IVIG);
CMV-cytotoxic T lymphocyte (CMV-CTL)
- From:
Organ Transplantation
2021;12(1):96-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the diagnostic value of quantitative detection of cytomegalovirus (CMV) DNA from different sources [plasma, sputum and bronchoalveolar lavage fluid(BALF)] for CMV pneumonia after allogeneic hematopoietic stem cell transplantation. Methods Clinical data of 405 recipients undergoing allogeneic hematopoietic stem cell transplantation were retrospectively analyzed. Among them, 19 recipients diagnosed with CMV pneumonia were assigned into the CMV pneumonia group, and 229 recipients with CMV viremia alone, 11 recipients without CMV pneumonia who received fiberoptic bronchoscopy and 16 recipients diagnosed with bacterial or fungal pneumonia based on pathogenic evidence receiving sputum culture were assigned into the control A, B and C groups, respectively. The incidence of CMV pneumonia was summarized. The CMV DNA load of specimens from different sources (plasma, sputum and BALF) of recipients with CMV pneumonia was analyzed. The clinical prognosis of recipients with CMV pneumonia was evaluated. Results Among 405 recipients undergoing allogeneic hematopoietic stem cell transplantation, 19 cases developed CMV pneumonia, and the overall incidence of CMV pneumonia was 4.7%(19/405). The CMV DNA load in the plasma, sputum and BALF of recipients with CMV pneumonia was higher than those in the control A, B and C groups (all P < 0.05). In the 19 recipients, 12 cases were cured after antiviral treatment and 7 died from treatment failure(3 cases abandoned treatment). The fatality was 37%(7/19). Conclusions Quantitative detection of CMV DNA in the plasma, sputum and BALF may increase the diagnostic rate of CMV pneumonia, thereby improving clinical prognosis of recipients undergoing allogeneic hematopoietic stem cell transplantation.
