诊断学理论与实践2024，Vol.23Issue(2)：180-183,4.DOI:10.16150/j.1671-2870.2024.02.012
急性粒-单核细胞白血病患者造血干细胞移植后微血栓形成凝血指标监测及治疗1例报告
A report on monitoring of coagulation indicators and treatment of microthrombus formation in AML(M4 type)after hematopoietic stem cell transplantation:a case report
沈连军 1吴蔚 1吉薇 1王红 1孙幸 1施青青 1孙梅 1顾健 1倪军1
作者信息
- 1. 扬州市血液学研究所实验室 江苏省苏北人民医院血液科,江苏 扬州 225001
- 折叠
摘要
Abstract
This article reports a case of acute myelomonocytic leukemia(AML-M4,CBFB gene positive)with lower limb microthrombus formation after haploidentical hematopoietic stem cell transplantation,and summarizes the experience of diagnosis and treatment.The patient received achieved complete remission(CR)after routine chemotherapy,but relapsed 2 years later and underwent a haploidentical hematopoietic stem cell transplantation.During routine treatment after trans-plantation,the patient's coagulation related indicators,including D-dimer(D-D),antithrombin Ⅲ(AT-Ⅲ),von Willebrand factor(vWF),fibrinogen degradation products(FDP)and fibrin monomer(FM),were dynamically observed.The patient ex-perienced jaundice and elevated transaminases around 100 days after transplantation,and underwent plasma exchange treatment three times through the right lower limb femoral vein catheterization.After removing the venous catheter for one week,there was left ankle concavea pitting edema of the left ankle.Vascular ultrasound examination indicated the forma-tion of microthrombus in the superficial venous plexus of the gastrocnemius muscle in the left lower limb.D-D,vWF,FDP,FM and other indicators were increased,while AT-Ⅲ levels was decreased.After 2 weeks of oral administration of 5 mg/d berritol for antithrombotic treatment,the above coagulation indicators gradually returned to normal,and the left lower limb intermuscular venous plexus thrombosis and limb swelling disappeared.Therefore,dynamic monitoring of coagulation indi-cators,such as D-D,AT-Ⅲ,vWF,FDP,and FM may serve as diagnostic indicators for predict transplant related microthrom-bus and hypercoagulable status,providing an experimental basis for effective anticoagulant treatment in clinical practice.关键词
凝血指标/亲缘半相合造血干细胞移植/微血栓形成/彩色多普勒超声Key words
Coagulation indicators/Closely related haploidentical hematopoietic stem cell transplantation/Micro-thrombus formation/Color doppler ultrasound分类
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沈连军,吴蔚,吉薇,王红,孙幸,施青青,孙梅,顾健,倪军..急性粒-单核细胞白血病患者造血干细胞移植后微血栓形成凝血指标监测及治疗1例报告[J].诊断学理论与实践,2024,23(2):180-183,4.
