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IR@PKUHSC  > 北京大学第二临床医学院  > 北京大学血液病研究所  > 期刊论文
学科主题: 血液病
题名:
巨细胞病毒特异性细胞毒性T淋巴细胞治疗造血干细胞移植后难治复发性巨细胞病毒感染的临床分析
其他题名: Cytomegalovirus specific cytotoxic T lymphocytes for treatment of refractory cytomegalovirus infection in patients following allogeneic hematopoietic stem cell transplantation
作者: 徐郑丽; 黄晓军; 孙于谦; 王峰蓉; 闫晨华; 张晓辉; 韩伟; 陈育红; 王景枝
关键词: 造血干细胞移植 ; 难治复发性巨细胞病毒感染 ; 巨细胞病毒特异性细胞毒性T淋巴细胞 ; Hematopoietic stem cell transplantation ; Refractory cytomegalovirus infections ; Cytomegalovirus specific cytotoxic T lymphocytes
刊名: 中华内科杂志
发表日期: 2015
DOI: 10.3760/cma.j.issn.0578-1426.2015.02.004
卷: 54, 期:2, 页:101-105
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 探讨体外扩增的巨细胞病毒(CMV)特异性细胞毒性T淋巴细胞(CMV-CTL)在难治复发性巨细胞病毒感染患者中的疗效及安全性.方法 给予28例难治复发性CMV感染患者输注CMV-CTL,其中19例患者CMV-CTL来自造血干细胞移植原供者,9例来自第三方供者.第1疗程输注1~2次,观察疗效和副作用;第1疗程完全缓解(CR)后复发的患者给予第2疗程治疗,输注1~2次.结果 21例CMV血症患者和7例CMV病患者接受CMV-CTL治疗,首次输注CTL中位治疗时间为移植后76(39 ~321)d,CTL输注中位细胞数为1.0(0.5~10.0)×10 7.第1疗程后,21例CMV血症患者和4例CMV病患者获得CR,CMV血症CR率为100%,CMV病CR率为4/7;获得CR的中位时间分别为首次CTL输注后9(3~23)d和7(4~18)d.6例CMV血症患者和1例CMV病患者CR后复发而给予第2疗程治疗,其中4例CMV血症患者和1例CMV病患者获得CR.5例次患者输注后出现移植物抗宿主病,均为轻中度皮肤受累.随访中6例死于CMV感染,2例死于其他移植后并发症.结论 初步结果显示,体外扩增的CMV-CTL输注治疗难治复发性CMV感染安全有效,但输注方案有待进一步完善. Objective To explore the efficacy and safety of expanding cytomegalovirus specific cytotoxic T lymphocytes (CMV-CTL) in vitro on refractory cytomegalovirus(CMV) infection.Methods A total of twenty-eight patients with refractory CMV infection following stem cell transplant (SCT) were treated with CMV-specific T cells,of which 19 cases were from hematopoietic stem cell donors and 9 from thirdparty donors.In the first course,CTL was infused once or twice and the efficacy and adverse effects were evaluated.If CMV infection relapsed after complete remission (CR),the second course would be given.Results Twenty-one patients with refractory CMV viremia and seven with CMV diseases were eligible for adoptive T-cell transfer.After a median of 76 (39-321) days post-transplant,patients received a median dose of 1.0 (0.5-10.0) × 107 CTL infusion in the first course.All twenty-one patients with CMV viremia and four patients with CMV diseases achieved CR after using 9 (3-23)and 7 (4-18)days respecitvely.Six patients with CMV viremia and one with CMV disease received the second course after recurrence.Another four patients with viremia and one with CMV disease had reached CR again.Five patients exhibited graftversus-host diseases(GVHD),all experiencing mild to moderate skin involvement.Six patients died of CMV infection and 2 of other transplantation-related complications.Conclusion Our preliminary results have shown that CMV-CTL infusion is effective against refractory cytomegalovirus infection following SCT,but therapeutic schedule still needs to be improved in further study.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/21347
Appears in Collections:北京大学第二临床医学院_北京大学血液病研究所_期刊论文

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作者单位: 100044,北京大学人民医院血液病研究所
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