Delukina M, Kapelushnik Y, Or R, Naparstek E, Slavin S, Nagler A
Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel.
Med Oncol. 1995 Jun;12(2):125-7. doi: 10.1007/BF01676714.
The case of a 5 year old male is described who had acute myeloblastic leukaemia (AML M5) and was in third remission when he underwent an allogeneic T cell depleted bone marrow transplantation (BMT). The bone marrow was from an HLA matched unrelated donor (MUD) who suffered from chronic idiopathic thrombocytopenic purpura (ITP). In spite of this, the patient had rapid platelet engraftment post BMT (> 50 x 10(9) l-1 on day 20). He is now 12 months post-transplantation and has normal platelet counts, without any clinical or laboratory evidence of ITP. Autoimmune manifestations such as ITP occurring in bone marrow recipients following BMT have been previously reported. Furthermore, severe and protracted thrombocytopenia is a known complication following MUD transplantation and with its respective high risk of graft versus host disease (GVHD). In this case, no signs of ITP could be detected in the recipient despite the fact that the donor had ITP. Our data suggest that in the absence of an alternative choice, a person with ITP should be considered as an appropriate donor for transplantation.
本文描述了一名5岁男性患者的病例，该患者患有急性髓细胞白血病（AML M5），在接受异基因T细胞去除的骨髓移植（BMT）时正处于第三次缓解期。骨髓来自一名患有慢性特发性血小板减少性紫癜（ITP）的HLA匹配无关供者（MUD）。尽管如此，患者在BMT后血小板迅速植入（第20天时>50×10⁹/L）。他现在移植后12个月，血小板计数正常，没有任何ITP的临床或实验室证据。BMT后骨髓受者出现如ITP这样的自身免疫表现此前已有报道。此外，严重且迁延的血小板减少是MUD移植后的已知并发症，且有各自较高的移植物抗宿主病（GVHD）风险。在本病例中，尽管供者患有ITP，但受者未检测到ITP迹象。我们的数据表明，在没有其他选择的情况下，患有ITP的人应被视为合适的移植供者。
