Klumpp T R
Division of Medical Oncology, Temple University Comprehensive Cancer Center, Philadelphia, Pennsylvania 19140.
Bone Marrow Transplant. 1991 Sep;8(3):159-70.
Normal hematopoiesis depends on successful interaction between the immune system and the hematopoietic system. The special circumstances of bone marrow transplantation (BMT) give rise to a number of well-recognized adverse interactions between these two systems, which are often manifested as peripheral blood cytopenias involving one or more cell lines. These so-called immunohematologic complications of BMT may develop following allogeneic, autologous, or syngeneic transplantation, and may occur as early as the day of transplantation or as late as several years afterward. Both autoimmune and alloimmune mechanisms have been implicated. The possibility of an immunohematologic complication should be considered any time an unexpected cytopenia develops in one or more cell lines in the post-transplant period. In addition, immunohematologic complications should be anticipated, and appropriate prophylaxis administered, when there is a major or minor mismatch between the donor and the recipient in the ABO and/or Rh blood group systems. Approaches to the prophylaxis, diagnosis, and treatment of these syndromes are reviewed herein.
正常造血依赖于免疫系统和造血系统之间的成功相互作用。骨髓移植（BMT）的特殊情况导致这两个系统之间出现许多公认的不良相互作用，这些相互作用通常表现为涉及一种或多种细胞系的外周血细胞减少。这些所谓的BMT免疫血液学并发症可在异基因、自体或同基因移植后发生，最早可在移植当天出现，最晚可在数年之后出现。自身免疫和同种免疫机制均与之相关。在移植后时期，一旦一种或多种细胞系出现意外的血细胞减少，就应考虑免疫血液学并发症的可能性。此外，当供体与受体在ABO和/或Rh血型系统中存在主要或次要不匹配时，应预期免疫血液学并发症并给予适当的预防措施。本文综述了这些综合征的预防、诊断和治疗方法。
