异基因造血干细胞移植后继发性血细胞减少10例  

Ten cases of secondary cytopenia after allogeneic hematopoietic stem cell transplantation

作　　者：王彩丽[1] 张景荣[1] 梁筱灵[1] 黄美玲 夏文 孟令恒 龙思琪 詹曌熙 郑仲征 WANG Caili;ZHANG Jingrong;LIANG Xiaoling;HUANG Meiling;XIA Wen;MENG Lingheng;LONG Siqi;ZHAN Zhaoxi;ZHENG Zhongzheng(Guiyang Maternal and Child Health Care Hospital,Guiyang Children′s Hospital,Guiyang 550000;Shanghai Tissuebank Biotechnology Co.,Ltd.,Shanghai 201318,China)

机构地区：[1]贵阳市妇幼保健院·贵阳市儿童医院血液科,贵阳5500001 [2]上海荻硕贝肯生物科技有限公司,上海201318

出　　处：《中国小儿血液与肿瘤杂志》2023年第3期181-185,190,共6页Journal of China Pediatric Blood and Cancer

摘　　要：目的探讨异基因造血干细胞移植后继发性血细胞减少病因及发病机制,为诊断及治疗提供思路。方法回顾性分析贵阳市妇幼保健院贵阳市儿童医院血液科2018年7月—2022年2月采用异基因造血干细胞移植治疗非恶性血液病继发性血细胞减少症共10例的临床资料,分析其病因,提出诊断治疗思路。结果异基因造血干细胞移植治疗非恶性血液病时继发性血细胞减少的发生率为41.7%,中位发生时间为移植后+55(+43~+152)d。表现为单系或多系血细胞减少,依据检查及治疗效果,分析病因包括继发性移植物排斥、继发性植入功能不良、自身免疫性血细胞减少。经治疗后10例的血细胞均恢复正常。结论继发性血细胞减少是异基因造血干细胞移植后常见并发症,常见原因有移植物排斥、植入功能不良、免疫性血细胞减少等,进行嵌合率、骨髓细胞学、外周血病毒DNA、抗人球蛋白实验等检查,及时鉴别病因并给予个性化治疗,可改善预后。Objective To explore the etiology and pathogenesis of secondary cytopenia after allogeneic hematopoietic stem cell transplantation,provide ideas for diagnosis and treatment.Methods We retrospectively analyzed the clinical data of patients with secondary cytopenia of nonmalignant hematological diseases treated by allogeneic hematopoietic stem cell transplantation from July 2018 to February 2022 in the Department of Hematology of Guiyang Maternal And Child Health Care Hospital.,then analyzed the causes,and put forward ideas for diagnosis and treatment.Results The incidence of secondary cytopenia in patients with nonmalignant hematological diseases treated with allogeneic hematopoietic stem cell transplantation was 41.7%.The medium time of occurrence was+55d(ranging from+43d to+152d)after transplantation.It manifested as 1-line or multi-line cytopenia.The causes of the disease included secondary graft rejection,secondary implantation dysfunction,and autoimmune cytopenia.After treatment,cytopenia of 10 cases recovered.Conclusions Secondary cytopenia is a common complication after allogeneic hematopoietic stem cell transplantation.The common causes are graft rejection,poor implantation function,immune hemopenia,etc.The prognosis can be improved by examining the chimerism rate,bone marrow cytology,peripheral blood virus DNA,antiglobulin test,and timely diagnosis of causes and personalized treatment.

关 键 词：异基因造血干细胞移植 血细胞减少 儿童 

分 类 号：R457.7[医药卫生—治疗学]