合并严重感染的重型再生障碍性贫血患儿造血干细胞移植  

Hematopoietic stem cell transplantation in severe aplastic anemia child patients with severe infection

作　　者：袁梦 秦茂权[1] 王彬[1] 朱光华[1] 杨骏[1] 吴润晖[1] 马洁[1] 李斯丹[1] YUAN Meng;QIN Maoquan;WANG Bin;ZHU Guanghua;YANG Jun;WU Runhui;MA Jie;LI Sidan(Hematology Center,Beijing Key Laboratory of Pediatric Hematology Oncology National Key Discipline of Pediatrics(Capital Medical University)Key Laboratory of Major Diseases in Children,Ministry of Education Beijing Children’s Hospital,Capital Medical University National Center for Children’s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院血液病中心,儿童血液病与肿瘤分子分型北京市重点实验室,儿科学国家重点学科,儿科重大疾病研究教育部重点实验室,北京100045

出　　处：《中国医药导报》2022年第11期95-98,102,共5页China Medical Herald

基　　金：北京市自然科学基金资助项目(7192065);首都医科大学“本科生科研创新”项目(XSKY2021340)。

摘　　要：重型再生障碍性贫血和极重型再生障碍性贫血病情危重,如果移植前患者合并严重感染,植入失败率及移植相关死亡率会相应增加。本文介绍首都医科大学附属北京儿童医院在接受造血干细胞移植前存在严重感染的3例患儿的感染类型、抗感染方案、移植时机、预处理和移植物抗宿主病预防方案及植入情况。从患儿预后情况可以看出合并感染并不是移植禁忌证,移植前应积极抗感染治疗,依据粒细胞缺乏伴发热指南,患者感染控制稳定后应尽快移植,难以控制时可行挽救性移植。Severe aplastic anemia and very severe aplastic anemia are critically ill,and the rate of implantation failure and transplant-related mortality will increase if the patients are associated with severe infection before transplantation.This article introduces the infection types,anti-infection programs,transplantation timing,pretreatment,graft-versus-host disease prevention programs and implantation situation of three children with severe infection before hematopoietic stem cell transplantation in Beijing Children’s Hospital,Capital Medical University.It can be seen from the prognosis of children that co-infection is not contraindicated for transplantation,anti-infection treatment should be actively carried out before transplantation,according to the guidelines of neutropenia with fever,the patient should be transplanted as soon as possible after infection control is stable,and salvage transplantation is feasible when it is difficult to control.

关 键 词：再生障碍性贫血 造血干细胞移植 感染 儿童 

分 类 号：R556.5[医药卫生—血液循环系统疾病]