论文部分内容阅读
目的 报道 1例患者异基因外周血干细胞移植 (allo PBSCT)后发生纯红细胞再生障碍 (PRCA) ,用血浆置换术和红细胞生成素 (Epo)治疗获得成功 ,并进行文献复习。 方法 1例M2a急性非淋巴细胞白血病患者完全缓解后进行allo PBSCT。供体为其胞妹 ,血型A型 ,受者O型 ;预处理方案包括全身照射和环磷酰胺 ,应用甲氨蝶呤和环孢霉素A预防移植物抗宿主病。移植后发生PRCA ,于 +10 3天给予血浆置换和Epo治疗 ,血浆置换每周 2次 ,共 5次 ,每次 2 0 0 0ml,Epo 30 0 0U ,每天 1次 ,皮下注射。结果 于移植后 131天网织红细胞达到 0 0 1,+15 4天Hb达 110g/L ,网织红细胞为 0 0 2。骨髓象正常 ,红系占 0 2 5 ,BFU E和CFU E均在正常范围。停用Epo后随访 5个月 ,造血一直正常。结论allo PBSCT后PRCA患者联合应用血浆置换和Epo ,红系造血可恢复正常。
Objective To report the occurrence of pure red cell aplasia (PRCA) after allogeneic peripheral blood stem cell transplantation (allo PBSCT) in one patient. Successful use of plasmapheresis and erythropoietin (Epo) therapy was performed and literature review was performed. METHODS: One allele of M2a acute nonlymphocytic leukemia was treated with allo-PBSCT after complete remission. The donor was its sister, blood type A, and receiver type O; preconditioning regimen included whole body irradiation and cyclophosphamide, and application of methotrexate and cyclosporin A to prevent graft-versus-host disease. PRCA occurred after transplantation. Plasma exchange and Epo treatment were given at +10 3 days. Plasma exchange was performed twice a week for 5 times, each time with 200 ml of Epo, 300 mg of Epo, once daily, subcutaneously. Results After 131 days of transplantation, reticulocytes reached 0 0 1, +15 4 days Hb reached 110g/L, and reticulocytes were 0 0 2. Bone marrow images were normal, erythroid accounted for 0.25, BFU E and CFU E were in the normal range. A follow-up of 5 months after stopping Epo, hematopoiesis has been normal. Conclusions After allo-PBSCT combined PRA patients with plasma exchange and Epo, erythroid hematopoiesis can return to normal.