造血干细胞移植术后环孢菌素A诱发急性胰腺炎的临床分析  

Acute Pancreatitis Induced by Cyclosporine A Following Allogeneic Hematopoietic Stem Cell Transplant

作　　者：郭荣[1] 杜欣[1] 翁建宇[1] 邓程新[1] 吴穗晶[1] 罗成伟[1] 

机构地区：[1]广东省人民医院血液科,广东广州510080

出　　处：《中国实验血液学杂志》2009年第2期472-475,共4页Journal of Experimental Hematology

基　　金：广东省自然科学基金资助项目(No.06020896);国家自然科学基金资助项目(No.30571771)

摘　　要：本文报道1例AML-M2a患者在造血干细胞移植中服用环孢素A(CsA)诱发急性胰腺炎并进行临床分析。1例49岁急性髓性白血病(AML-M2a)患者,在进行同胞HLA相合造血干细胞移植术后20天并发急性胰腺炎。预处理方案采用改良Bu/Cy方案,移植物抗宿主病(GVHD)预防包括环孢菌素A(CsA)、短程甲氨蝶呤(MTX)及抗胸腺细胞球蛋白(ATG)。结果表明:尽管患者腹部CT及彩超检查均显示胰腺无异常,但临床及实验室检查均支持急性胰腺炎的诊断。经过全身支持治疗及CsA减量患者最终得以缓解。结论:CsA是导致急性胰腺炎的可能诱因。Pancreatitis has not been reported in allogeneic stem cell transplant（allo-SCT） recipients with cyclosporine in China. This article presented a case of acute pancreatitis in a 49-year-old patient with AML-M2a who received allogeneic stem cell transplant from her HLA identical sister. The preparative regimen consisted of busulfan and cyclophosphamide. The cyclosporine A, short-term methotrexate and antilymphocyte globufin （ATG）, were used to prevent the graft-versus-host disease （GVHD）. Clinical and laboratory signs of acute pancreatitis were found in the patient on day 20 post-transplant. A diagnosis of acute pancreatitis was made although the pancreas was apparently normal at abdominal contrast-enhanced tomography and ultrasonography. She recovered with supportive care and reduction of cyclosporine dose. In conclusion, cyclosporine is the probable cause of pancreatitis in this patient.

关 键 词：环孢素A(CsA) 胰腺炎 造血干细胞移植(HSCT) 

分 类 号：R576[医药卫生—消化系统] R733.71[医药卫生—内科学]