Intracranial hemorrhage following bone marrow transplantation: an autopsy study of 58 patients
Intracranial hemorrhage following bone marrow transplantation: an autopsy study of 58 patients
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DOI：
10.1038/sj.bmt.1703315
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发表时间：
2002-01-01
影响因子：
4.8
通讯作者：
de Medeiros, CR
中科院分区：
文献类型：
--
作者：
Bleggi-Torres, LF;Werner, B;de Medeiros, CR
回顾了1987年7月至1998年6月间180例骨髓移植后死亡的尸检资料，其中58例（32.2%）曾发生颅内出血（ICH）。对患者年龄、性别、基础疾病、准备方案、免疫预防、慢性和急性GVHD、患者生存率、移植物的定位和大小进行评价。男33例，女25例，平均年龄23.4岁。进行BMT的主要基础疾病包括SAA（n = 21）、CML（n = 13）和AML（n = 10）。发现40例患者有脑实质内出血，35例有蛛网膜下腔出血，8例有硬膜下出血。在16例病例中，中枢神经系统出血非常广泛，被认为是死亡的主要原因。在性别方面没有显著的统计学差异（P = 0.217），年龄（P = 0.296），基础疾病（P = 0.352），预备方案（P = 0.07），免疫预防（P = 0.914）、慢性和急性移植物抗宿主病（分别为P 0.107和P = 0.631）和生存率（P 0.701）。然而，脑出血患者中CNS被定义为主要死亡原因的病例数高于非脑出血患者（n = 16 vs 15）（P = 0.011）。我们的结论是，脑出血是常见的，并有一个显着的死亡率以下BMT。
Autopsy files of 180 patients were reviewed, who died after BMT between July 1987 and June 1998 and 58 (32.2%) cases, who had experienced intracranial hemorrhage (ICH) were selected. Age, sex, underlying disease, preparatory regimens, immunoprophylaxis, chronic and acute GVHD, survival of the patients and localization and size of hemorrhages were evaluated. There were 33 males and 25 females, with a mean age of 23.4 years. The main underlying disorders for which BMT was performed included SAA (n = 21), CML (n = 13) and AML (n = 10). Forty patients were found to have intraparenchymal hemorrhage, 35 had subarachnoid hemorrhage and eight patients had subdural hemorrhage. In 16 cases the CNS hemorrhage was so extensive that it was considered to be the main cause of death. There was no significant statistical difference concerning sex (P = 0.217), age (P = 0.296), underlying disease (P = 0.352), preparatory regimens (P = 0.07), immunoprophylaxis (P = 0.914), chronic and acute graft-versus-host disease (P 0.107 and P = 0.631, respectively) and survival (P 0.701) when comparing patients with or without ICH. However, the number of cases in which the CNS was defined as the main cause of death was higher among patients with ICH than in patients without ICH (n = 16 vs 15) (P = 0.011). We conclude that ICH is common and has a significant mortality rate following BMT.