异基因骨髓移植后100天内3例患者出现骨髓发育异常改变。

Myelodysplastic changes in three cases within 100 days after allogeneic bone marrow transplantation.

作者信息

Okamoto T, Kanamaru A, Okada M, Kawaguchi K, Saheki K, Takatsuka H, Fujimori Y, Takemoto Y, Kohsaki M, Kakishita E

机构信息

2nd Department of Internal Medicine, Hyogo College of Medicine, Japan.

出版信息

Int J Hematol. 1996 Feb;63(2):155-60. doi: 10.1016/0925-5710(95)00429-7.

DOI:10.1016/0925-5710(95)00429-7

PMID:8867726

Abstract

Three patients with severe aplastic anemia, acute promyelocytic leukemia (M3) and chronic myelogenous leukemia, developed myelodysplastic changes with trilineage morphological abnormalities in a few months following allogenic bone marrow transplantation (BMT). Morphologically dysplastic changes associated with moderate-severe anemia, leukopenia and/or thrombocytopenia appeared on day 40, day 62 and day 68 after BMT. A ferrokinetics study clearly showed ineffective erythropoiesis in one patient. Hematopoietic cells were shown to be of donor-origin in all three cases. The levels of vitamin B12 and folic acid were normal. Laboratory tests showed no signs of hemolysis or fragmentation of red blood cells. Although the cause of aberrant hematopoiesis compatible with MDS within 100 days post-BMT remains to be determined, cytomegalovirus infection, ganciclovir and/or graft-versus host disease (GVHD) might be associated with this myelodysplasia following allogeneic BMT.

摘要

三名患有严重再生障碍性贫血、急性早幼粒细胞白血病（M3）和慢性粒细胞白血病的患者，在异基因骨髓移植（BMT）后的几个月内发生了骨髓增生异常改变，并伴有三系形态学异常。与中度至重度贫血、白细胞减少和/或血小板减少相关的形态学发育异常分别出现在BMT后的第40天、第62天和第68天。一项铁动力学研究清楚地显示一名患者存在无效红细胞生成。在所有三例中，造血细胞均显示为供体来源。维生素B12和叶酸水平正常。实验室检查未显示红细胞溶血或破碎的迹象。尽管BMT后100天内与骨髓增生异常综合征（MDS）相符的异常造血原因仍有待确定，但巨细胞病毒感染、更昔洛韦和/或移植物抗宿主病（GVHD）可能与异基因BMT后的这种骨髓发育异常有关。