Fujisawa S, Maruta A, Sakai R, Taguchi J, Tomita N, Ogawa K, Kodama F, Takahashi K, Shibayama S, Kobayashi S, Ikuta K, Okubo T
Department of Hematology and Chemotherapy, Kanagawa Cancer Center, Yokohama-city, Japan.
Transpl Int. 1996;9(5):506-8. doi: 10.1007/BF00336830.
A 34-year-old man with acute myelocytic leukemia (AML: MO) and a 32-year-old woman with AML: M2 developed pure red cell aplasia (PRCA) after receiving a major ABO incompatible bone marrow transplant (BMT). The first patient responded to recombinant human erythropoietin (rhEPO) therapy, while the second did not. The second patient also received methylprednisolone (m-PSL) but developed reticulocytosis and hemolysis after the administration of m-PSL. Plasmapheresis was then performed and the patient promptly recovered from hemolysis and PRCA. We conclude that close attention must be paid when treating PRCA following major ABO-incompatible BMT with rhEPO and m-PSL, as there is always the potential for massive hemolysis.
一名34岁的急性髓细胞白血病（AML：MO）男性患者和一名32岁的AML：M2女性患者在接受主要ABO血型不合的骨髓移植（BMT）后发生了纯红细胞再生障碍性贫血（PRCA）。首例患者对重组人促红细胞生成素（rhEPO）治疗有反应，而第二例患者则无反应。第二例患者还接受了甲泼尼龙（m-PSL）治疗，但在给予m-PSL后出现了网织红细胞增多和溶血。随后进行了血浆置换，患者迅速从溶血和PRCA中康复。我们得出结论，在用rhEPO和m-PSL治疗主要ABO血型不合的BMT后的PRCA时，必须密切关注，因为始终存在发生大量溶血的可能性。
