Tezcan A Z, Tezcan H, Gastineau D A, Armitage J O, Haire W D
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330.
Bone Marrow Transplant. 1994 Sep;14(3):487-90.
Persistent thrombocytopenia and thrombotic complications are commonly observed in bone marrow transplant (BMT) patients. We describe two incidents following BMT in which heparin may have played a contributory role. One patient developed subclavian venous thrombosis following autologous BMT in spite of the severe thrombocytopenia. The second patient, who received an HLA-matched sibling allogeneic BMT, developed thrombocytopenia after a normal platelet recovery. Because of the clinical evidence and a normocellular bone marrow biopsy result, heparin-induced thrombocytopenia was suspected and heparin was discontinued. In 2 weeks, the patient was transfusion free and her platelet count returned to normal levels. These two cases demonstrate that heparin-induced thrombocytopenia may be responsible for some cases of post-BMT thrombocytopenia and thrombosis.
持续性血小板减少和血栓并发症在骨髓移植（BMT）患者中很常见。我们描述了两例骨髓移植后的事件，其中肝素可能起到了促成作用。一名患者在自体骨髓移植后出现锁骨下静脉血栓形成，尽管存在严重的血小板减少。第二名患者接受了 HLA 匹配的同胞异基因骨髓移植，在血小板正常恢复后出现血小板减少。由于临床证据和骨髓活检结果正常细胞，怀疑是肝素诱导的血小板减少症并停用了肝素。两周后，患者无需输血，血小板计数恢复到正常水平。这两例病例表明，肝素诱导的血小板减少症可能是一些骨髓移植后血小板减少和血栓形成病例的原因。
