Gross T G, Hoge F J, Jackson J D, Sammut P H, Warkentin P I
Department of Pathology, University of Nebraska Medical Center, Omaha 68198-3135.
Bone Marrow Transplant. 1994 Aug;14(2):333-7.
A 15-year-old girl developed massive, fatal eosinophilic disease following autologous bone marrow transplantation (BMT) for Hodgkin's disease (HD). Prior to autologous BMT, the erythrocyte sedimentation rate (ESR) was elevated, with active HD, but eosinophilia was absent. Post-autologous BMT, ESR and peripheral eosinophilia were observed to correlate with respiratory symptoms. Initial evaluation revealed no recurrent tumor, infection or other identifiable etiology. A diagnosis of chronic eosinophilic pneumonia was made following lung biopsy. A complete response was initially achieved with steroid therapy; however, when steroid therapy was tapered, the eosinophilia and elevated ESR recurred with worsening respiratory symptoms. Terminally, severe pulmonary disease developed and recurrent HD was found in lung, lymph nodes and bone marrow. During episodes of eosinophilia, the patient's serum stimulated her bone marrow as well as control marrow to produce predominantly eosinophilic colonies. Eosinophilic colony production was not observed with patient's sera obtained prior to or during autologous BMT or with control sera. This patient died of eosinophilic inflammatory disease following autologous BMT. The etiology of this disease was not definitely identified but appeared to be due to an eosinophilic-stimulating factor which developed after autologous BMT.
一名15岁女孩在接受自体骨髓移植（BMT）治疗霍奇金病（HD）后发生了严重的致命性嗜酸性粒细胞疾病。在自体BMT之前，红细胞沉降率（ESR）因活动性HD而升高，但无嗜酸性粒细胞增多。自体BMT后，观察到ESR和外周血嗜酸性粒细胞增多与呼吸道症状相关。初步评估未发现复发性肿瘤、感染或其他可识别的病因。肺活检后诊断为慢性嗜酸性粒细胞性肺炎。最初使用类固醇治疗取得了完全缓解；然而，当类固醇治疗逐渐减量时，嗜酸性粒细胞增多和ESR升高复发，呼吸道症状加重。最终，患者出现严重肺部疾病，在肺、淋巴结和骨髓中发现复发性HD。在嗜酸性粒细胞增多发作期间，患者的血清刺激其骨髓以及对照骨髓主要产生嗜酸性粒细胞集落。在自体BMT之前或期间获得的患者血清以及对照血清均未观察到嗜酸性粒细胞集落产生。该患者在自体BMT后死于嗜酸性粒细胞炎症性疾病。该疾病的病因尚未明确，但似乎是由于自体BMT后产生的一种嗜酸性粒细胞刺激因子所致。
