摘要

It is widely suspected, yet controversial, that infection plays an etiologic role in the development of acute lymphoblastic leukemia (ALL), the most common childhood cancer and a disease with a confirmed prenatal origin in most cases. We investigated infections at diagnosis and then assessed the timing of infection at birth in children with ALL and age, gender, and ethnicity matched controls to identify potential causal initiating infections. Comprehensive untargeted virome and bacterial analyses of pretreatment bone marrow specimens (n = 127 ALL in comparison with 38 acute myeloid leukemia cases in a comparison group) revealed prevalent cytomegalovirus (CMV) infection at diagnosis in childhood ALL, demonstrating active viral transcription in leukemia blasts as well as intact virions in serum. Screening of newborn blood samples revealed a significantly higher prevalence of in utero CMV infection in ALL cases (n = 268) than healthy controls (n = 270) (odds ratio [OR], 3.71, confidence interval [CI], 1.56-7.92, P = .0016). Risk was more pronounced in Hispanics (OR=5.90, CI=1.89-25.96) than in non-Hispanic whites (OR=2.10 CI= 0.69-7.13). This is the first study to suggest that congenital CMV infection is a risk factor for childhood ALL and is more prominent in Hispanic children. Further investigation of CMV as an etiologic agent for ALL is warranted.

译文

感染在急性淋巴细胞白血病 (ALL) 的发展中起着病因的作用,这一点被广泛怀疑,但仍有争议, 最常见的儿童癌症,在大多数情况下是一种产前确诊的疾病。我们调查了诊断时的感染,然后评估了 ALL 患儿出生时感染的时间,以及年龄、性别和种族匹配的对照,以确定潜在的致病起始感染。预处理骨髓标本 (n = 127,全部与对照组中的 38 例急性髓系白血病病例进行比较) 的全面的非靶向病毒和细菌分析显示出流行的巨细胞病毒 (CMV) 儿童 ALL 的诊断感染,在白血病肿瘤中显示活跃的病毒转录以及血清中完整的病毒粒子。对新生儿血液样本的筛查显示,在所有病例中 (n = 268) 子宫内 CMV 感染的患病率明显高于健康对照组 (n = 270) (比值比 [或],3.71, 置信区间 [CI],1.56-7.92,P =。 0016)。西班牙裔人群 (OR = 5.90,CI = 1.89-25.96) 的风险比非西班牙裔白人人群 (OR = 2.10 CI = 0.69-7.13) 更为明显。这是第一项表明先天性巨细胞病毒感染是儿童 ALL 的危险因素,在西班牙裔儿童中更为突出的研究。CMV 作为所有疾病的病原体的进一步研究是必要的。

Cytomegalovirus infection

儿科 病毒感染 临床研究术语
概述  :  

 人巨细胞病毒(HCMV)是最常见的先天性感染之一,呈全球性分布,在全球活产婴儿中HCMV先天性感染率约为0.7%,是新生儿罹患先天性感音神经性耳聋、视力障碍、智力发育迟缓和病毒性肝炎、病毒性肺炎等疾病的常见原因,严重者可导致流产、死胎、早产和新生儿死亡。 HCMV感染分类   (1)原发感染:指初次感染HCMV,在被感染前缺乏HCMV-IgG抗体,在感染后出现HCMV-IgG抗体转化。(2)复发感染:由潜伏在人体内的HCMV再激活引起的感染。(3)再

cytomegalovirus /,saɪtə(ʊ)'meg(ə)lə(ʊ),vaɪrəs/  /,saɪto'mɛɡəlovaɪrəs/

       n. [病毒] 巨细胞病毒

同根词   cytokinesis n. [细胞] 胞质分裂;细胞浆移动

cytology n. 细胞学

cytogenetics n. 细胞遗传学

       Cytomegalovirus is one of the five known herpes viruses that infect humans. 巨细胞是人类所接触到的五类疱疹病毒之一。 

 

infection  /ɪn'fekʃ(ə)n/   /ɪn'fɛkʃən/

       n. 感染;传染;影响;传染病

       Their intention was to encourage those patient’s immune systems to attack the tumours by trainingthem to recognise the signs of active cytomegalovirus infection. 他们的打算是通过训练病人免疫系统来识别活跃的巨细胞病毒感染的特征来达到促使免疫系统攻击肿瘤的目的。

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