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小儿白血病患者输血相关的HIV感染(两例报告)

Transfusion-Associated HIV Infection in Pediatric Leukemia Patients (Two Case Reports).

作者信息

Chen Xuejun, Zhou Mingming, Ning Botao, Song Hua, Yang Shilong, Tang Yongmin

机构信息

Division of Clinical Laboratory, Children's Hospital, Zhejiang University School of Medicine, Zhejiang, China.

出版信息

Iran J Pediatr. 2012 Sep;22(3):417-20.

Abstract

BACKGROUND

Leukemia is the second most malignant tumor in children. The chemotherapy induced anemia (CIA) and hemorrhage are the most popular side-effects due to the myelosuppression of chemotherapy. So far, multitransfusion is still the timely and effective measure in curing these complications. The acquisition of HIV infection and subsequent development of AIDS by component transfusion from donors at risk is well known, and prognosis of HIV infection is particularly severe in patients with leukemia.

CASE PRESENTATION

We report two leukemic cases that were infected with HIV through transfusion. The first patient was totally transfused with 16 U RBC, 20 U platelets and 820 ml fresh frozen plasma, and later test showed that his first used FFP carried the HIV. For the second 2 U RBC, 5 U platelets and 1500 ml fresh frozen plasma were transfused to her. Late test of her used blood products showed that the fourth RBC carried the HIV. Both results were confirmed by the local Center for Disease Control (CDC). They were not transfused before the diagnosis of leukemia. Their parents were healthy with negative HIV-Ab.

CONCLUSION

Since the two leukemic patients suffered transfusion-associated HIV with poor prognosis, we must take more efforts to utilize blood products judiciously, manage blood donors, test blood samples etiologically, shorten HIV testing "window periods" and develop preventive vaccination against HIV to reduce the incidence as low as possible.

摘要

背景

白血病是儿童中第二常见的恶性肿瘤。化疗所致贫血(CIA)和出血是化疗骨髓抑制最常见的副作用。到目前为止,多次输血仍是治疗这些并发症的及时有效措施。通过输注来自高危献血者的成分血而感染HIV并随后发展为艾滋病是众所周知的,而白血病患者感染HIV后的预后尤其严重。

病例报告

我们报告两例因输血感染HIV的白血病病例。首例患者共输注了16单位红细胞、20单位血小板和820毫升新鲜冰冻血浆,后来检测显示其首次使用的新鲜冰冻血浆携带HIV。第二例患者输注了2单位红细胞、5单位血小板和1500毫升新鲜冰冻血浆。对其使用的血液制品后期检测显示第四单位红细胞携带HIV。两项结果均得到当地疾病控制中心(CDC)的确认。他们在白血病诊断之前未接受过输血。他们的父母健康,HIV抗体阴性。

结论

鉴于这两例白血病患者发生了与输血相关的HIV感染且预后不良,我们必须更加努力地合理使用血液制品、管理献血者、对血样进行病因学检测、缩短HIV检测“窗口期”并研发针对HIV的预防性疫苗,以尽可能降低发病率。

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本文引用的文献

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AIDS. 2007 Dec;21 Suppl 8:S33-8. doi: 10.1097/01.aids.0000304694.54884.06.

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