Salomone T, Tosi P, Raiti C, Stanzani M, Leopardi G, Miglio F, Bandini G
Emergency Department, S. Orsola Hospital, Bologna, Italy.
Dig Dis Sci. 1999 Jun;44(6):1124-7. doi: 10.1023/a:1026611804261.
This study investigated the clinical relevance of acute pancreatitis in allogeneic hemopoietic stem cell (bone marrow or peripheral blood) transplants (BMT). We studied 26 patients undergoing BMT. The preparative regimen was busulfan and cyclophosphamide in 17 patients and total body irradiation and cyclophosphamide in 9 patients. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A and short-term methotrexate in all 26 patients. The pancreas was studied using amylase and lipase serum levels, abdominal contrast-enhanced tomography, and/or ultrasound. Clinical and laboratory signs of acute pancreatitis were found in two patients with acute hepatointestinal GVHD, and in one patient with acute hepatic GVHD and cytomegalovirus infection. This patient died of multiorgan failure, with interstitial acute pancreatitis at autopsy; the other two patients recovered with general supportive care and GVHD therapy. We suggest that in the patients with complications after BMT, particularly acute hepatic/hepatointestinal GVHD, and cytomegalovirus infection, the possibility of acute pancreatitis should be considered.
本研究调查了异基因造血干细胞（骨髓或外周血）移植（BMT）中急性胰腺炎的临床相关性。我们研究了26例接受BMT的患者。17例患者的预处理方案为白消安和环磷酰胺，9例患者为全身照射和环磷酰胺。所有26例患者的移植物抗宿主病（GVHD）预防均包括环孢素A和短期甲氨蝶呤。通过血清淀粉酶和脂肪酶水平、腹部增强CT和/或超声对胰腺进行研究。在2例急性肝肠GVHD患者以及1例急性肝GVHD合并巨细胞病毒感染的患者中发现了急性胰腺炎的临床和实验室体征。该患者死于多器官功能衰竭，尸检发现有间质性急性胰腺炎；另外2例患者通过一般支持治疗和GVHD治疗后康复。我们建议，对于BMT后出现并发症的患者，尤其是急性肝/肝肠GVHD和巨细胞病毒感染的患者，应考虑急性胰腺炎的可能性。
