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异基因造血干细胞移植后迟发性非感染肺部并发症4例分析 被引量：1

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摘要 目的探讨异基因造血干细胞移植(allo-HSCT)后迟发性非感染肺部并发症(LONIPC)的临床特点、诊断及治疗。方法回顾分析4例LONIPC患者的临床特点及诊疗经过,统计分析相关资料。结果 4例患者于移植后4～24个月发生LONIPC,均存在口腔、眼、皮肤慢性移植物抗宿主病(慢性GVHD),临床表现为咳嗽、呼吸困难,肺CT表现:毛玻璃样改变,不规则片状实变影,结节状影,多发不规则条状阴影,肺功能检测表现为阻塞性通气功能障碍,皮质激素辅以环孢霉素治疗有效,1例治疗后随诊至2010年10月无病存活,合并感染治疗效果差,2例均死于进行性呼吸衰竭,1例迁延不愈。结论 LONIPC可能是慢性GVHD肺部的特殊表现,慢性GVHD的存在是诊断LONIPC的重要佐证,移植后定期监测肺CT及肺功能甚为必要,早期皮质激素治疗可使部分患者获得缓解。
作者 朱卫健 王玫玫 杜均祥 李小亮 龚五星
机构地区 暨南大学医学院附属珠海医院 广东省珠海市人民医院血液肿瘤科
出处 《广东医学》 CAS CSCD 北大核心 2011年第5期600-601,共2页 Guangdong Medical Journal
关键词 异基因 造血干细胞移植 迟发性非感染肺部并发症 移植物抗宿主病
分类号 R457.7 [医药卫生—治疗学]
  • 相关文献

参考文献8

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二级参考文献9

  • 1石红霞,黄晓军,刘代红,许兰平,张耀臣,陆道培.造血干细胞移植后特发性肺炎综合征的临床分析[J].中华医学杂志,2005,85(33):2360-2362. 被引量：6
  • 2Khurshid I,Anderson LC.Non-infectious pulmonary complications after bone marrow transplantation.Postgrad Med J,2002,78:257-262.
  • 3Patriarca F,Skert C,Sperotto A,et al.Incidence,outcome,and risk factors of late-onset noninfectious pulmonary complications after unrelated donor stem cell transplantation.Bone Marrow Transplant,2004,33:751-758.
  • 4Duncker C,Dohr D,Harsdorf S,et al.Non-infectious lung complications are closely associated with chronic graft-versus-host disease:a single center study of incidence,risk factors and outcome.Bone Marrow Transplant,2000,25:1263-1268.
  • 5Sakaida E,Nakaseko C,Harima A,et al.Late-onset noninfectious pulmonary complications after allogeneic stem cell transplantation are significantly associated with chronic graft-versus-host disease and with the graft-versus-leukemia effect.Blood,2003,102:4236-4242.
  • 6Afessa B,Litzow MR,Tefferi A.Bronchiolitis obliterans and other late onset non-infectious pulmonary complications in hematopoietic stem cell transplantation.Bone Marrow Transplant,2001,28:425-434.
  • 7Palmas A,Tefferi A,Myers JL,et al.Late-onset noninfectious pulmonary complications after allogeneic bone marrow transplantation.Br J Haematol,1998,100:680-687.
  • 8Cooke KR,Krenger W,Hill G,et al.Host reactive donor T cells are associated with lung injury after experimental allogeneic bone marrow transplantation.Blood,1998,92:2571-2580.
  • 9刘启发,孙竞,张钰,徐丹,刘晓力,徐兵,孟凡义,周淑芸.环孢素A+甲氨蝶呤+霉酚酸酯+抗胸腺细胞球蛋白四联方案预防无关供体造血干细胞移植中的移植物抗宿主病[J].第一军医大学学报,2003,23(11):1143-1145. 被引量：17

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广东医学
2011年 第5期

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