Corso S, Vukelja S J, Wiener D, Baker W J
Department of Hematology-Oncology, Brooke Army Medical Center, San Antonio, TX 78234-6200.
Bone Marrow Transplant. 1993 Sep;12(3):301-3.
Autologous BMT performed in a 57-year-old woman with relapsed large cell lymphoma was complicated by two consecutive episodes of diffuse alveolar hemorrhage (DAH). The second episode occurred immediately after infusion of autologous BM. DAH is an increasingly recognized complication of autologous BMT and carries a high mortality. It is characterized by dyspnea, cough, bilateral pulmonary infiltrates and progressively bloodier aliquots of bronchoalveolar lavage fluid. The pathogenesis is probably multifactorial involving an initial insult to lung endothelium with inflammatory cells serving as the mediators of subsequent injury. The rapid development of DAH following marrow infusion strongly implicates DMSO as a potential cause in our patient.
一名57岁复发大细胞淋巴瘤女性患者接受自体骨髓移植后，出现了连续两次弥漫性肺泡出血（DAH）并发症。第二次发作在输注自体骨髓后立即发生。DAH是自体骨髓移植中越来越被认识到的一种并发症，死亡率很高。其特征为呼吸困难、咳嗽、双侧肺部浸润以及支气管肺泡灌洗液体中血液成分逐渐增多。发病机制可能是多因素的，涉及对肺内皮的初始损伤，炎症细胞作为后续损伤的介质。在我们的患者中，骨髓输注后DAH迅速发展强烈提示二甲基亚砜（DMSO）是一个潜在原因。
