单倍型造血干细胞移植后原发性植入功能不良对巨细胞病毒肺炎的影响

OBJECTIVE: To retrospectively analyze the impact of primary PGF on CMV pneumonia in patients who have undergone haplo-HSCT. METHODS: The clinical data of 122 patients who underwent haplo-HSCT at the Peking University Institute of Hematology from 2011–2012 were retrospectively reviewed. The incidence rate of CMV pneumonia between PGF and good graft function (GGF) was compared, and the factors were analyzed. In addition, outcomes in PGF patients with CMV pneumonia have been described. RESULTS: Total 122 patients were retrospectively reviewed, and of these, 26 (21.3%) had PGF, while 96 (78.7%) had GGF. In addition, 15 patients had CMV pneumonia, and the median time to the development of CMV pneumonia was 103 (31–262) days; the 1-year cumulative incidence of CMV pneumonia was 12.3% (95% CI 6.2%–18.4%). In patients with primary PGF and GGF after Haplo-HSCT, the incidence of CMV pneumonia was 30.8% (8/26) and 7.3% (7/96), respectively (P=0.002). Moreover, 24 patients had CMV viremia (92.3%), while of the 96 GGF patients, 79 (82.3%) had CMV viremia (P=0.212). In multivariate analysis, the results showed that primary PGF had a significant influence on CMV pneumonia (P=0.005). Compared with those without CMV pneumonia, patients with CMV pneumonia had poorer overall survival 37.3% (95% CI 11.2%–63.4%) vs. 78.9% (95% CI 72.0%–87.6%) (χ(2)=16.361, P<0.001). The 1-year overall survival (OS) was 25.0% (95% CI 0%–55.0%) and 50.0% (95% CI 26.9%–73.1%) (χ(2)=4.656, P=0.031) in PGF patients with (8/26) and without (18/26) CMV pneumonia. CONCLUSION: The incidence of cytomegalovirus pneumonia in patients with primary poor graft function increases and the survival rate decreases.