Imoto Shion, Murayama Tohru, Nagai Kenichi, Hirabayashi Norio, Tanaka Chiaki, Misawa Mahito, Kawasaki Keiichiro, Mizuno Ishikazu, Koizumi Tamio, Kajimoto Kazuyoshi, Takahashi Takayuki, Hara Hiroshi, Kumagai Shunichi, Saigo Katsuyasu
Hyogo Red Cross Blood Center, 1-4-5 Wakinohamakaigan-dori, Chuo-ku, Kobe, Hyogo, Japan.
Lab Hematol. 2005;11(2):131-6. doi: 10.1532/LH96.04065.
Differentiating thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) from other complications following allogeneic hematopoietic cell transplantation (HPCT) requires objective, reliable markers. To this purpose, we assessed the clinical usefulness of sequential quantified analysis of fragmented red blood cells (FRC) with the Sysmex XE-2100 automated hematology analyzer. The correlation between manual and automated counting was significant (r = 0.917; P < .0001). Of 25 cases, the peak FRC percentage (FRC%) exceeded 1.3% after allogeneic HPCT in 11 cases, and lactate dehydrogenase levels were elevated in 5 of these 11 cases. Two patients received diagnoses of TTP-HUS following allogeneic HPCT, and both had initial diagnoses of acute graft-versus-host disease. In both cases, the sharp increase in the FRC% to >3% simultaneously with clinical exacerbation was helpful for differentiating TTP-HUS following allogeneic HPCT from other complications. We conclude that FRC% data sequentially obtained by an automated count seem to be useful as an objective marker of TTP-HUS following allogeneic HPCT.
将血栓性血小板减少性紫癜 - 溶血性尿毒症综合征（TTP - HUS）与异基因造血细胞移植（HPCT）后的其他并发症区分开来需要客观、可靠的标志物。为此，我们使用Sysmex XE - 2100全自动血液分析仪评估了破碎红细胞（FRC）的连续定量分析在临床上的实用性。手工计数与自动计数之间的相关性显著（r = 0.917；P <.0001）。在25例病例中，11例异基因HPCT后FRC百分比峰值（FRC%）超过1.3%，这11例中有5例乳酸脱氢酶水平升高。两名患者在异基因HPCT后被诊断为TTP - HUS，且最初均被诊断为急性移植物抗宿主病。在这两个病例中，FRC%急剧增加至>3%同时伴有临床症状加重，这有助于将异基因HPCT后的TTP - HUS与其他并发症区分开来。我们得出结论，通过自动计数连续获得的FRC%数据似乎可作为异基因HPCT后TTP - HUS的客观标志物。
