临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (5): 396-.doi: 10.3969/j.issn.1000-3606.2021.05.017

• 继续医学教育 • 上一篇    

儿童造血干细胞移植后EB 病毒相关淋巴组织增殖性疾病的诊疗进展

习必鑫,胡群   

  1. 华中科技大学同济医学院附属同济医院儿童血液科(湖北武汉 430030)
  • 发布日期:2021-05-07

Recommendation for diagnosis and treatment of Epstein-Barr virus related post-transplant lymphoproliferative disorder following hematopoietic stem cell transplant in children

XI Bixin, HU Qun   

  1. The Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030 , Hubei, China
  • Published:2021-05-07

摘要: EB病毒相关淋巴组织增殖性疾病(EBV-PTLD)是儿童造血干细胞移植(HSCT)后的严重并发症之一。减低 强度的预处理(RIC)、抗胸腺细胞球蛋白(ATG)的使用、移植物抗宿主病(GVHD)、巨细胞病毒感染等多种高危因素与儿 童EBV-PTLD发生密切相关。由于目前移植后EBV-PTLD相对少见,且缺乏统一的治疗方案,因此儿童EBV-PTLD临床 诊疗极具挑战性。文章旨在综述儿童EBV-PTLD的发病机制、危险因素、诊断标准及最新治疗进展,为进一步完善适用于 儿童EBV-PTLD的诊疗规范提供建议。

关键词: 移植后淋巴组织增生性疾病; EB病毒; 临床诊疗; 儿童

Abstract: The Epstein-Barr virus related post-transplant lymphoproliferative disorder (EBV-PTLD) is one of the deadliest complications after hematopoietic stem cell transplantation in children. Multiple risk factors have been associated with the onset of EBV-PTLD such as reduced intensity conditioning (RIC), use of antithymocyte globulin (ATG), graft-versus-host disease (GVHD), cytomegalovirus reactivation, etc. There is no clear consensus on the treatment of EBV-PTLD in children transplant recipients due to few clinical trials and the rarity of the disease. This article aims to explore the entity of EBV-PTLD in childhood hematopoietic stem cell transplantation recipients, expanding on pathogenesis, risk factors, clinical diagnosis and recent treatment strategy, as such to highlight the gaps in knowledge needed for building a perfect treatment paradigm suitable for all pediatric patients.

Key words: post-transplant lymphoproliferative disorder; Epstein-Barr virus; clinical diagnosis and treatment; child