Siegert E, Lauterbach I, Weissbach G
Klinik für Kinderheilkunde der Medizinischen Akademie Carl Gustav Carus, Dresden.
Folia Haematol Int Mag Klin Morphol Blutforsch. 1990;117(2):265-70.
There is reported about the treatment of refractory thrombocytopenia in a 9 years old boy following the autologous bone marrow transplantation for acute lymphoblastic leukaemia. The megakaryocytes were found diminished in the bone marrow smears. Controls of the thrombocyte count and the kinetics with radioactively labeled platelets of a donor spoke in favour of immunothrombocytopenia. Threatening bleeding complications challenged the use of all treatment possibilities. The irradiation of the spleen was without any success. After the splenectomy the thrombocyte count increased slowly, but after a remarkable lag phase, however. A diminished reproduction capacity of the bone marrow graft for special cell sorts has to be taken into account in such cases. The usual cytodynamics after splenectomy cannot be expected at all.
报道了一名9岁男孩在接受急性淋巴细胞白血病自体骨髓移植后难治性血小板减少症的治疗情况。骨髓涂片显示巨核细胞减少。对血小板计数及供体放射性标记血小板动力学的监测结果支持免疫性血小板减少症的诊断。严重的出血并发症促使尝试各种治疗方法。脾脏照射治疗未取得任何成效。脾切除术后血小板计数缓慢上升，但有明显的延迟期。在这类病例中，必须考虑骨髓移植对特定细胞类型的再生能力下降。完全不能期望脾切除术后会出现通常的细胞动力学变化。
