Zhang Yi-zhuo, Da Wan-ming, Zhang Bo-Long, Gao Chun-Ji, Han Xiao-pin, Huang Wen-rong, Jing Yu, Li Hong-hua, Zhao Yu, Bo Jian, Wang Shu-hong, Zhu Hai-yan, Jin Hai-jie
Department of Hematology, PLA General Hospital, Beijing 100853, China.
Zhonghua Xue Ye Xue Za Zhi. 2006 Jun;27(6):366-9.
To explore the incidence, pathogenesis, risk factors and effective treatment of pulmonary complications after allogeneic peripheral blood stem cell transplantation (allo-PBSCT).
Pulmonary complications in 70 patients received allo-PBSCT were analyzed.
Thirty one episodes were observed in 26 patients. Among them episodes were infectious complications, including bacteria pneumonia, pulmonary fungus disease, CMV interstitial pneumonia and tuberculosis, some cases were caused by two pathogens, and 11 episodes were noninfectious complications, including late-onset noninfectious pulmonary complications (LONIPCs) (n=9), pulmonary edema (n=1) and interstitial pneumonia (n=1). The overall mortality was 12.9%. Graft-versus-host disease (GVHD) prophylaxis without MTX, severe acute GVHD and extensive chronic GVHD were high risk factors for pulmonary complications and advanced disease at transplantation, extensive chronic GVHD were significantly associated with the incidence of LONIPCs.
Pulmonary disease is the main complication occurred in patients undergoing allo-PBSCT. It is of greatly importance to treat pathogens specifically and diagnose LONIPCs in its early stage.
探讨异基因外周血干细胞移植（allo-PBSCT）后肺部并发症的发生率、发病机制、危险因素及有效治疗方法。
分析70例行allo-PBSCT患者的肺部并发症。
26例患者共发生31次并发症。其中感染性并发症，包括细菌性肺炎、肺真菌病、巨细胞病毒间质性肺炎和肺结核，部分病例由两种病原体引起，11次为非感染性并发症，包括迟发性非感染性肺部并发症（LONIPCs）（n = 9）、肺水肿（n = 1）和间质性肺炎（n = 1）。总死亡率为12.9%。未使用甲氨蝶呤预防移植物抗宿主病（GVHD）、重度急性GVHD和广泛慢性GVHD是肺部并发症的高危因素，移植时疾病进展、广泛慢性GVHD与LONIPCs的发生率显著相关。
肺部疾病是allo-PBSCT患者的主要并发症。针对性治疗病原体及早期诊断LONIPCs至关重要。
