摘要
目的研究主要ABO血型不合异基因造血干细胞移植(allo-HSCT)后患者纯红细胞再生障碍(PRCA)的发病情况及危险因素。方法分析移植后患者PRCA的发病危险因素,比较抗A凝集素与抗B凝集素对红系造血恢复的影响。结果100例ABO血型主要及主次要均不合allo-HSCT患者中,12例发生PRCA。A供O者9例,A供B者1例,B供O者2例。有抗A凝集素的患者(10例)较有抗B凝集素的患者(2例)易发生PRCA(P<0.05)。PRCA的发生不影响急性移植物抗宿主病(GVHD)或巨细胞病毒(CMV)感染的发生。发生PRCA时血型转换的中位时间为150.5d,显著长于无PRCA发生患者(60.0d)(P<0.05);红系恢复的中位时间为203.5d,显著长于无PRCA发生患者(76.0d)(P<0.05)。有抗A凝集素的患者血型转换中位时间为90.0d,显著长于有抗B凝集素的患者(55.0d)(P<0.05);红系恢复中位时间为98.0d,长于有抗B凝集素者(80.0d)(P>0.05),但差异无统计学意义。结论PRCA是ABO血型不合移植的合并症之一。A供O是主要ABO血型不合allo-HSCT后PRCA发病的危险因素。
Objectives To study clinical characteristics and outcome of pure red cell aplasia （PRCA） following major ABO-incompatible allogeneie hematopoietie stem cell transplantation （allo-HSCT）. Methods Variables including sex, age, stem cell source, granulocyte engraftment time, blood transfusion and isoagglutinin type against donor RBC were analyzed to identify risk factors for the development of PRCA. Results Twelve of 100 patients received major ABO-incompatible allo-HSCT developed PRCA,with out any effect on incidence of aGVHD and CMV infection. ABO blood groups of recipient/donor pairs of these twelve PRCA patients were O/A in nine, B/A in one and O/B in two. Patients with anti-A isoagglutinins against donor RBC developed PRCA more frequently than those with anti-B （10/49 vs 2/49）, Median duration to the recovery of erythropoiesis tended to be longer in patients with PRCA （ PRCA vs non-PRCA, 203.5 vs. 76 days, P 〈 0.05）, Median durations to the disappearance of incompatible isoagglutinins tended to be longer in patients with PRCA （PRCA vs. non-PRCA, 150.5 vs. 60 days,P 〈0.05 ）and in those with anti-A isoagglutinins（ anti-A vs anti-B, 90 vs 55 clays , P 〈 0.05 ）. Conclusion ABO blood group of O/A in recipient/donor pair was the only high risk factor for PRCA after major ABO-incompatible allo-HSCT.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2005年第9期548-550,共3页
Chinese Journal of Hematology
