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镰状细胞贫血合并遗传性血液系统疾病患者的临床病程:一家三级血液学中心的经验

Clinical Course of Patients With Sickle Cell Anemia and Co-inherited Hematological Disorders: Experience at a Tertiary Hematological Centre.

作者信息

Patel Swati, Krishnan V P, Kanvinde Purva, Mudaliar Sangeeta, Shah Nitin, Swami Archana, Desai Mukesh, Agarwal Bharat

机构信息

Department of Pediatric Hematology and Oncology, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400054 India.

出版信息

Indian J Hematol Blood Transfus. 2020 Oct;36(4):754-757. doi: 10.1007/s12288-020-01303-x. Epub 2020 Jun 12.

Abstract

To study the clinical course of patients with sickle cell anemia and coinherited hematological disorders. Retrospective analysis of clinical data of patients enrolled at our hospital over last 7 years was performed. Eighty four patients of symptomatic sickling disorders were registered during this period, comprising of HbSS (n = 49), HbS-β thalassemia (n = 28), HbS-HbD disease (n = 5), HbS-β thalassemia with G6PD deficiency (n = 1) and HbS-hemophilia A (n = 1). Among HbS-β thalassemia, 18% suffered from occasional pain crises and 27% required occasional blood transfusion. 40% patients with HbS-HbD disease required occasional blood transfusions, one patient was transfusion dependent, while none suffered from crisis episodes. Patient with HbS-β thalassemia with G6PD deficiency had increased transfusion requirement during first 3 years of life, which decreased after that. Patient with HbS and severe hemophilia A had only one episode of severe bleeding, suffered from 1 crisis episode. In conclusion, HbA reduces severity of HbS in HbS-β + thalassemia. HbS-HbD disease can manifest as a transfusion dependent illness. HbSS reduces severity of G6PD deficiency after first few years of life. HbSS and hemophilia coinheritance ameliorates symptoms of hemophilia.

摘要

研究镰状细胞贫血合并其他血液系统疾病患者的临床病程。对我院过去7年收治患者的临床资料进行回顾性分析。在此期间共登记了84例有症状的镰状细胞疾病患者,包括HbSS(n = 49)、HbS-β地中海贫血(n = 28)、HbS-HbD病(n = 5)、合并G6PD缺乏的HbS-β地中海贫血(n = 1)和HbS-甲型血友病(n = 1)。在HbS-β地中海贫血患者中,18%偶尔发生疼痛危象,27%需要偶尔输血。40%的HbS-HbD病患者需要偶尔输血,1例患者依赖输血,无一例发生危象。合并G6PD缺乏的HbS-β地中海贫血患者在生命的前3年输血需求增加,之后减少。合并严重甲型血友病的HbS患者仅发生1次严重出血,有1次危象发作。总之,在HbS-β + 地中海贫血中,HbA降低了HbS的严重程度。HbS-HbD病可表现为依赖输血的疾病。在生命的最初几年后,HbSS降低了G6PD缺乏的严重程度。HbSS与血友病的合并遗传改善了血友病的症状。

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