巨细胞病毒肠炎对重度肠道移植物抗宿主病患者预后的影响

OBJECTIVE: To explore risk factors, clinical characteristics and prognosis of CMV enteritis combined with severe intestinal graft-versus-host disease (GVHD). METHODS: The data of 80 intestinal grade Ⅲ/Ⅳ GVHD patients from January 2005 to September 2015 in hematology of PKUPH were retrospectively analyzed. All patients received colonoscopy and all GVHD diagnoses were based on clinical manifestation, colonoscopy and biopsies. All patients were divided into biopsy-proven CMV enteritis and control groups. Various characteristics, clinical manifestation and transplantation related mortality were compared. RESULTS: A total of 18 patients were diagnosed with biopsy-proven CMV enteritis, including 14 antigens positive, 2 inclusion bodies positive (1 positive for both antigen and inclusion body) and 3 intestinal mucosa CMV PCR positive. The median diagnosis time for CMV enteritis was 65 days (range, 27 to 278 days) after transplantation. There was no statistically difference for baseline (age, gender, underlying disease, status of disease, et al) between two groups. The NRM between CMV enteritis and control groups was significantly different (61.1% vs. 33.9%,P=0.044). CONCLUSION: CMV enteritis was a risk factor of NRM for grade Ⅲ/Ⅳ intestinal GVHD.