Ucar Kalust
Pacific Shores Medical Group, Glendale, California 91204, USA.
Oncology (Williston Park). 2002 Sep;16(9 Suppl 10):163-70.
The hallmark of hemolysis is shortened red blood cell survival in the peripheral blood. Hemolysis results in anemia only when bone marrow cannot keep up with the rate of red cell destruction. Even though anemia is very commonly observed in most cancer patients, hemolytic anemias are rather rare. Acute or chronic hemolysis, when present can impact on quality of life adversely, especially when bone marrow has limited compensation capacity. The underlying etiologies and pathophysiologies of the varying types of hemolytic anemias differ vastly, and there are numerous disorders causing red blood cell destruction that result in a similar clinical presentation. Careful review of the peripheral blood smear can provide invaluable information in diagnosing the underlying disorder. The majority of the nonhemolytic anemias have a chronic and stable course. In hemolytic disorders, however, the severity of the hemolysis can also create life-threatening emergencies. Management of hemolytic anemias depend on the diagnosis. Thus clinicians often face added pressure to determine the causative disorder rapidly so that timely interventions can be planned. Thus, even though they are not very common, hemolytic anemias remain a big challenge in the practice of hematology and oncology.
溶血的标志是外周血中红细胞存活时间缩短。只有当骨髓无法跟上红细胞破坏速度时，溶血才会导致贫血。尽管在大多数癌症患者中贫血很常见，但溶血性贫血却相当罕见。急性或慢性溶血一旦出现，会对生活质量产生不利影响，尤其是当骨髓代偿能力有限时。不同类型溶血性贫血的潜在病因和病理生理学差异很大，并且有许多导致红细胞破坏的疾病会导致相似的临床表现。仔细检查外周血涂片可为诊断潜在疾病提供宝贵信息。大多数非溶血性贫血病程呈慢性且稳定。然而，在溶血性疾病中，溶血的严重程度也可能引发危及生命的紧急情况。溶血性贫血的治疗取决于诊断结果。因此，临床医生常常面临更大压力，需要迅速确定病因，以便制定及时的干预措施。所以，尽管溶血性贫血并不常见，但在血液学和肿瘤学实践中仍然是一个巨大挑战。
