PDF(Pubmed)
Abstract：
In contrast to transplant recipients, there is a paucity of data regarding frequency and clinical significance of viraemia in children receiving conventional chemotherapy. In a prospective observational study, we assessed the frequency of and clinical impact of viraemia with cytomegalovirus (CMV), Epstein-Barr virus (EBV), adenovirus, human herpesvirus-6 (HHV6) and herpes-simplex virus 1/2 (HSV1/2) in paediatric cancer patients at diagnosis, at a routine examination during intensive chemotherapy, and during febrile neutropenia (FN). Seventy-nine patients (median age 6 years; 66 children with haematological malignancies) were included in the study. Overall, 362 blood samples were analysed, 72 from the time at diagnosis (11.1% with positive PCR result), 118 during a regular control after chemotherapy (11.0% positive), and 159 during FN (8.8% positive). The overall positivity rate was 9.6% (CMV 3.3%, HHV6 2.7%, HSV 2.2%, EBV 0.8% and adenovirus 0.3%). There were no significant differences between FN episodes with and without viraemia in terms of duration of fever or neutropenia/lymphopenia, severity of mucositis (> II0), incidence of diarrhea and ICU admission. Our results indicate that viraemia in paediatric cancer patients generally does not have a major clinical impact, and may help in the decision regarding the indication of routine evaluation for viraemia in febrile neutropenic, but otherwise asymptomatic children.
摘要：
与移植接受者相比，关于接受常规化疗的儿童中病毒血症的频率和临床意义的数据很少。在一项前瞻性观察研究中，我们评估了巨细胞病毒（CMV）病毒血症的频率和临床影响，EB病毒(EBV)腺病毒，人类疱疹病毒-6（HHV6）和单纯疱疹病毒1/2（HSV1/2）在儿科癌症患者的诊断，在强化化疗期间的常规检查中，以及在发热性中性粒细胞减少症（FN）期间。79名患者（中位年龄6岁；66名血液恶性肿瘤儿童）被纳入研究。总的来说,分析了362份血液样本，72从诊断的时间（11.1％，PCR结果阳性），118在化疗后的常规控制（11.0％阳性），和159FN（8.8%为阳性）。总阳性率为9.6%(CMV3.3%，HHV62.7%，HSV2.2%,EBV0.8%和腺病毒0.3%)。在发烧或中性粒细胞减少/淋巴细胞减少的持续时间方面，有和没有病毒血症的FN发作之间没有显着差异。粘膜炎的严重程度（>II0），腹泻和ICU入院的发生率。我们的结果表明，小儿癌症患者的病毒血症通常不会对临床产生重大影响。并可能有助于决定对发热性中性粒细胞减少症中病毒血症进行常规评估的指征，但其他无症状的儿童。
