中国输血杂志2023，Vol.36Issue(11)：995-999,5.DOI:10.13303/j.cjbt.issn.1004-549x.2023.11.005
ABO血型次要不合的异基因造血干细胞移植合并过客淋巴细胞综合征患者的诊治
Diagnosis and treatment of passenger lymphocyte syndrome following secondary ABO-incompatible allogeneic hema-topoietic stem cell transplantation
摘要
Abstract
Objective To investigate the clinical characteristics and diagnosis and treatment of passenger lymphocyte syn-drome(PLS)in patients following allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods A total of 489 patients who underwent allo-HSCT in Suzhou Hongci Hematology Hospital were retrospectively enrolled.The clinical process,diagnosis and treatment measures and prognosis of four patients complicated with PLS after transplantation were analyzed.Re-sults Among the 489 patients,4 were diagnosed with PLS.The blood types of donor/recipient ABO were all secondary incom-patible(The blood type of donors were O and the recipients were A or B).The overall incidence of PLS in allo-HSCT was 0.82%(4/489)and 2.2%(4/179)in transplants with donor/recipient secondary incompatible ABO-blood types.PLS occured in 6-13 days after donor stem cell infusion.Clinical manifestations were dizziness and fatigue,low back pain,jaundice,deepening urine,rapid decrease in hemoglobin on laboratory tests,elevated indirect bilirubin and lactate dehydrogenase,positive uro-bilinogen,positive direct anti-human globulin test(DAT),and anti-A or anti-B antibodies against recipient red blood cells were detected in plasma.After the treatment of O-type washed red blood cells,methylprednisolone,gamma globulin,rituximab and other treatments,the hemolysis was improved.All patients achieved engraftment of neutrophil and platelet.Red blood cell transfusion was halted in 3 weeks.Conclusion PLS is a rare complication of allo-HSCT,which mainly occurs in allo-HSCT pa-tients with secondary incompatibility of ABO blood group of donor/recipient.The clinical prognosis is good after properly treatment.关键词
过客淋巴系统综合征/造血干细胞移植/ABO血型系统/溶血Key words
passenger lymphocyte syndrome(PLS)/hematopoietic stem cell transplantation(HSCT)/ABO blood group system/hemolysis分类
医药卫生引用本文复制引用
邵迎春,周士源,朱倩,窦广刚,马骁,吴小津,马超..ABO血型次要不合的异基因造血干细胞移植合并过客淋巴细胞综合征患者的诊治[J].中国输血杂志,2023,36(11):995-999,5.基金项目
苏州市卫生健康委科研项目LCZX202101) （）
