Thrombotic microangiopathy associated with reactivation of human herpesvirus-6 following high-dose chemotherapy with autologous bone marrow transplantation in young children

被引:61
作者
Matsuda, Y
Hara, J
Miyoshi, H
Osugi, Y
Fujisaki, H
Takai, K
Ohta, H
Tanaka-Taya, K
Yamanishi, K
Okada, S
机构
[1] Osaka Univ, Grad Sch Med, Dept Pediat, Osaka, Japan
[2] Osaka Univ, Grad Sch Med, Dept Microbiol, Osaka, Japan
关键词
autologous bone marrow transplantation; thrombotic microangiopathy; HHV-6;
D O I
10.1038/sj.bmt.1702003
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Thrombotic microangiopathy (TMA) is a serious complication of BMT, Several factors are important in the etiology of TMA, such as cyclosporin A, GVHD, irradiation, intensive conditioning chemotherapy and infection, which cause damage to vascular endothelial cells leading to activation of these cells, We describe two young children with TMA following high-dose chemotherapy with autologous BMT, Development of TMA was accompanied by reactivation of HHV-6, which was identified by both an increase in the copy number of HHV-6 DNA in the peripheral blood and a significant increase in antibody titers to HHV-6. Thus, it was suggested that reactivation of HHV-6 together with high-dose chemotherapy played an important role in the pathogenesis of TMA in these patients, Since HHV-6 is known to infect vascular endothelial cells, and CMV which is virologically closely related to HHV-6, has been reported to be a pathogen that causes TMA, infection with HHV-6 of vascular endothelial cells may induce TMA via damage and activation of these cells.
引用
收藏
页码:919 / 923
页数:5
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