异基因造血干细胞移植后带状疱疹病毒感染的危险因素分析.

BACKGROUND: Allogeneic hematopoietic stem cell transplantation is an important or even the only method to cure a variety of hematological diseases. Herpes zoster virus infection after transplantation seriously affects the quality of life. OBJECTIVE: To explore the risk factors of varicella-zoster virus infection in patients after allogeneic hematopoietic stem cell transplantation, in order to reduce the incidence of varicella-zoster virus infection after allogeneic hematopoietic stem cell transplantation and the severity of the disease. METHODS: Clinical data of 654 patients who underwent allogeneic hematopoietic stem cell transplantation in the First Affiliated Hospital of Zhengzhou University from November 2016 to June 2021 were retrospectively analyzed to explore the related factors of the varicella-zoster virus infection after allogeneic hematopoietic stem cell transplantation. RESULTS AND CONCLUSION: 66 of the 654 patients developed varicella-zoster virus infection after allogeneic hematopoietic stem cell transplantation, and the morbidity was 10.1%. The average age of patients who infected with varicella-zoster virus was 21.5 (4-62) years old, and the average time of varicella-zoster virus infection was 149 days (19-1 179 days). The main manifestations were regional skin herpes, including 7 cases of herpes zoster encephalitis, 17 cases of post herpetic neuralgia, and 1 case of right ear deafness. The main treatments were topical use of ganciclovir gel, intravenous infusion of penciclovir, application of immunoglobulin to improve immune function and reduce the dosage of immunosuppressant. The median time of treatment was 11 days (3-38 days), and the herpes was scabbed or improved. Incidence of varicella-zoster virus infection after allogeneic hematopoietic stem cell transplantation was related to age (χ² = 7.816, P=0.005), whether fludarabine was used in the pretreatment scheme (χ² =5.004, P=0.025), whether there was cytomegalovirus infection (χ² =5.983, P=0.014), and the primary diseases (χ² =4.860, P=0.027). It was not related to the type of transplantation and the source of stem cells. The varicella-zoster virus infection is a common complication of allogeneic hematopoietic stem cell transplantation. It usually occurs within one year after transplantation. Patients with risk factors should pay more attention to prevention and treatment. Preventive application of antiviral drugs can reduce the incidence of varicella-zoster virus infection. [ABSTRACT FROM AUTHOR]