Современные подходы к лечению цитомегаловирусной инфекции у онкогематологических больных
Аннотация
Проблема цитомегаловирусной (ЦМВ) инфекции является чрезвычайно серьезной и актуальной у иммунокомпрометированных пациентов. Препаратом, рутинно используемым для контроля ЦМВ-инфекции в данной когорте пациентов, является ганцикловир. К сожалению, такие проблемы, как миелотоксичность и развитие лекарственной резистентности, нередко ограничивают возможность его применения. Хорошей альтернативой является валганцикловир, эффективность которого подтверждена в клинических исследованиях. Проблема контроля ЦМВ-инфекции не является решенной, даже несмотря на внедрение в практику высокоэффективных методов ранней диагностики и упреждающей терапии. Использование иммуноаблативных препаратов (таких как алемтузумаб или антитимоцитарный глобулин), а также трансплантация гемопоэтических стволовых клеток от альтернативных доноров являются факторами высокого риска развития жизнеугрожающих висцеральных ЦМВ-ассоциированных осложнений. Новые методы контроля ЦМВ активно исследуются в настоящее время. В частности, одним из перспективных направлений является культивирование и клиническое использование ЦМВ-специфических Т-лимфоцитов.
Список литературы
1. Avery R.K., Bolwell B.J., Yen-Lieberman B. et al. Use of leflunomide in an allogeneic bone marrow transplant recipient with refractory cytomegalovirus infection. Bone Marrow Transplant 2004;34:1071–5.
2. Stocchi R.,Ward K.N., Fanin R., Baccarani M., Apperley J.F. Management of human cytomegalovirus infection and disease after allogeneic bone marrow transplantation. Haematol 1998;84:71–9.
3. Taylor-Wiedeman J., Sissons J.G., Borysiewicz L.K., Sinclair J.H. Monocytes are a major site of persistence of human cytomegalovirus in peripheral blood mononuclear cells. J Gen Virol 1991;72:2059–64.
4. Soderberg-Naucler C., Fish K.N., Nelson J.A. Reactivation of latent human cytomegalovirus by allogeneic stimulation of blood cells from healthy donors. Cell 1997;91:119–26.
5. Michelson S. Interaction of human CMV with monocytes/macrophages: a love-hate relationship. Pathol Biol Paris 1997; 45:146–58.
6. Meyers J.D., Flournoy N., Thomas E.D. Risk factors for cytomegalovirus infection after human marrow transplantation. J Infect Dis 1986;153:478–88.
7. Reusser P., Fisher L.D., Buckner C.D. et al. Cytomegalovirus infection after autologous bone marrow transplantation: occurrence of cytomegalovirus disease and effect on engraftment. Blood 1990;75:1888–94.
8. Ljungman P., Biron P., Bosi A. et al. Cytomegalovirus interstitial pneumonia in autologous bone marrow transplant recipients. Infectious Disease Working Party of the European Group for Bone Marrow Transplantation. Bone Marrow Transplant 1994;13(2):209–12.
9. Konoplev S., Champlin R.E., Giralt S. et al. Cytomegalovirus pneumonia in adult autologous blood and marrow transplant recipients. Bone Marrow Transplant 2001;27:877–81.
10. Osarogiagbon R.U., Defor T.E., Weisdorf M.A. et al. CMV antigenemia following bone marrow transplantation: risk factors and outcomes. Biol Blood Marrow Transplant 2000;6:280–8.
11. Ljungman P., Aschan J., Lewensohn- Fuchs I. et al. Results of different strategies for reducing cytomegalovirus-associated mortality in allogeneic stem cell transplant recipients. Transplantation 1998;66:1330–4.
12. Takenaka R., Gongo H., Tanimoto K. t al. Increased incidence of cytomegalovirus (CMV) infections and CMV-associated disease after allogeneic bone marrow transplantation from unrelated donors. Bone Marrow Transplant 1997;19:241–8.
13. Reusser P., Riddell S., Meyers J., Greenberg P.D. Cytotoxic T-lymphocyte response to cytomegalovirus after human allogeneic bone marrow transplantation: pattern of recovery and correlation with cytomegalovirus infection and disease. Blood 1991;78:1373–80.
14. Small T.N., Papadopoulos E.B., Boulad F. et al. Comparison of immune reconstitution after unrelated and related T-celldepleted bone marrow transplantation: effect of patient age and donor leukocyte infusions. Blood 1999;93:467–80.
15. Rubin R.H. Clinical approach o infection in the compromised host. In: Infection in the Organ Transplant Recipient; Rubin R.H., Young L.S. (eds.). New York, NY, Kluwer Academic Press, 2002. Pp. 573–679.
16. Boeckh M., Nichols W.G., Papanicolaou G. et al. Cytomegalovirus in hematopoietic stem cell transplant recipients: current status, known challenges, and future strategies. Biol Blood Marrow Transplant 2003;9:543–58.
17. Meyers J.D., Ljungman P., Fisher L.D. Cytomegalovirus excretion as a predictor of cytomegalovirus disease after marrow transplantation: importance of cytomegalovirus viremia. J Infect Dis 1990;162:373–80.
18. Ljungman P., Engelhard D., Link H. et al. Treatment of interstitial pneumonitis due to cytomegalovirus with ganciclovir and intravenous immune globulin: experience of European Bone Marrow Transplant Group. Clin Infect Dis 1992;14:831–5.
19. Yanada M., Yamamoto K., Emi N. et al. Cytomegalovirus antigenemia and outcome of patients treated with preemptive ganciclovir: retrospective analysis of 241 consecutive patients undergoing allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2003;32:801–7.
20. Takatsuka H., Wakae T., Mori A. et al. Endothelial damage caused by cytomegalovirus and human herpesvirus-6. Bone Marrow Transplant 2003;31:475–9.
21. Ljungman P., Griffiths P., Paya C. Definitions of CMV infection and disease in transplant recipients. Clin Infect Dis 2002;34:1094–7.
22. Nguyen Q., Champlin R., Giralt S. et al. Late cytomegalovirus pneumonia in adult allogeneic blood and marrow transplant recipients. Clin Infect Dis 1999;28:618–23.
23. Randolph-Habecker J., Iwata M, Torok-Storb B. Cytomegalovirus mediated myelosuppression. J Clin Virol 2002;25 (Suppl 2):S51–6.
24. Nguyen Q., Estey E., Raad I. et al. Cytomegalovirus pneumonia in adults with leukemia: an emerging problem. Clin Infect Dis 2001;32:539–45.
25. O’Brien S., Ravandi F., Riehl T. et al. Valganciclovir prevents cytomegalovirus reactivation in patients receiving. Blood 2008;111(4):1816–9.
26. Han X.Y. Epidemiologic analysis of reactivated cytomegalovirus antigenemia in patients with cancer. J Clin Microbiol 2007;45:1126–32.
27. Ljungman P., de la Camara R., Cordonnier C. et al. Management of CMV, HHV-6, HHV-7 and Kaposi-sarcoma herpesvirus (HHV-8) infections in patients with hematological malignancies and after SCT. Bone Marrow Transplant 2008;42: 227–40.
28. Bowden R.A., Slichter S.J., Sayers M. A comparison of filtered leukocyte-reduced and cytomegalovirus (CMV) seronegative blood products for the prevention of transfusion-associated CMV infection after marrow transplantation. Blood 1995;86:3598–603.
29. Bass E.B., Powe N.R., Goodman S.N. et al. Efficacy of immune globulin in preventing complications of bone marrow transplantation: a meta-analysis. Bone Marrow Transplant 1993;12:273–82.
30. Guglielmo B.J., Wong-Beringer A., Linker C.A. Immune globulin therapy in allogeneic bone marrow transplant: a critical review. Bone Marrow Transplant 1994;13:499–510.
31. Messori A., Rampazzo R., Scroccaro G., Martini N. Efficacy of hyperimmune anticytomegalovirus immunoglobulins for the prevention of cytomegalovirus infection in recipients of allogeneic bone marrow transplantation: a meta-analysis. Bone Marrow Transplant 1994;13:163–7.
32. Zikos P., Van Lint M.T., Lamparelli T. et al. A randomized trial of high dose polyvalent intravenous immunoglobulin (HDIgG) vs. cytomegalovirus (CMV) hyperimmune IgG in allogeneic hemopoietic stem cell transplants (HSCT). Haematologica 1998;83:132–7.
33. Keating M.J., Flinn I., Jain V. et al. Therapeutic role of alemtuzumab (Campath-1H) in patients who have failed fludarabine: results of a large international study. Blood 2002;99:3554–61.
34. Rai K.R., Freter C.E., Mercier R.J. et al. Alemtuzumab in previously treated chronic lymphocytic leucemia patients who also had received fludarabine. J Clin Oncol 2002;20:3891–7.
35. Osterborg A., Dyer M.J., Bunjes D. et al. Phase II multicenter study of human CD52 antibody in previously treated chronic lymphocytic leukemia: European study group of CAMPATH-1H Treatment in chronic lymphocytic leukemia. J Clin Oncol 1997;15:1567–74.
36. Boeckh M., Zaia J.A., Jung D. et al. A study of the pharmacokinetics, antiviral activity, and tolerability of oral ganciclovir for CMV prophylaxis in marrow transplantation. Biol Blood Marrow Transplant 1998;4:13–9.
37. Goodrich J.M., Bowden R.A., Fisher L. et al. Ganciclovir prophylaxis to prevent cytomegalovirus disease after marrow transplant. Ann Intern Med 1993;118:173–8.
38. Winston D.J., Ho W.G., Bartoni K. et al. Ganciclovir prophylaxis of cytomegalovirus infection and disease in allogeneic bone marrow transplant recipients. Results of placebo-controlled, double-blind trial. Ann Intern Med 1993;118:179–84.
39. Reusser P., Einsele H., Lee J. et al. Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Randomized multicenter trial of foscarnet versus ganciclovir for preemptive therapy of cytomegalovirus infection after allogeneic stem cell transplantation. Blood 2002;99: 1159–64.
40. Allice T., Busca A., Locatelli F. et al. Valganciclovir as pre-emptive therapy for cytomegalovirus infection post-allogenic stem cell transplantation: implications for the emergence of drug-resistant
41. cytomegalovirus. J Antimicrob Chemother 2009;63(3):600–8.
42. van der Heiden P.L., Kalpoe J.S., Barge R.M. et al. Oral valganciclovir as pre-emptive therapy has similar efficacy on cytomegalovirus DNA load reduction as intravenous ganciclovir in allogeneic stem
43. cell transplantation recipients. Bone Marrow Transplant 2006;37:693–8.
44. Ayala E., Greene J., Sandin R. et al. Valganciclovir is safe and effective as preemptive therapy for CMV infection in allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2006;37:851–6.
45. Busca A., de Fabritiis P., Ghisetti V. et al. Oral valganciclovir as preemptive therapy for cytomegalovirus infection post allogeneic stem cell transplantation. Transpl Infect Dis 2007;9:102–7.
46. Candoni A., Simeone E., Tiribelli M. et al. What is the optimal dosage of valganciclovir as preemptive therapy for CMV infection in allogeneic hematopoietic SCT. Bone Marrow Transplant 2008;42:207–8.
47. Takenaka K., Eto T., Nagafuji K. et al. Fukuoka Blood and Marrow Transplant Group (FBMTG). Oral valganciclovir as preemptive therapy is effective for cytomegalovirus infection in allogeneic hematopoietic stem cell transplant recipients. Int J Hematol 2009;89:231–7.
48. Peggs K.S., Verfuerth S., Mackinnon S. Induction of cytomegalovirus (CMV)- specific T-cell responses using dendritic cells pulsed with CMV antigen: a novel culture system free of live CMV virions. Blood 2001;97:994–1000.
49. Zaia J.A., Sissons J.G., Riddell S. et al. Status of cytomegalovirus prevention and treatment in 2000. Hematology (Am Soc Hematol EducProgram) 2000;2000:339–55.
Для цитирования:
Балашов Д.Н. Современные подходы к лечению цитомегаловирусной инфекции у онкогематологических больных. Онкогематология. 2013;8(1):46-51. https://doi.org/10.17650/1818-8346-2013-8-1-46-51
For citation:
Balashov D.N. Trends in the treatment of cytomegalovirus infection in oncohematological patients. Oncohematology. 2013;8(1):46-51. (In Russ.) https://doi.org/10.17650/1818-8346-2013-8-1-46-51
Просмотров: 621
Послать статью по эл. почте 