Red cell fragmentation (schistocytosis) after bone marrow transplantation
Red cell fragmentation (schistocytosis) after bone marrow transplantation
复制标题
骨髓移植后红细胞碎裂（片状红细胞增多症）
作者：
A. Zomas;R. Saso;R. Powles;H. Mackay;S. Singhal;S. Singhal;J. Treleaven;J. Mehta
红细胞碎裂通常是血栓性微血管病的最早征兆。对58例同种异体移植和32例自体移植受者的+14、+28和+42天的血片进行盲检，以确定血吸虫病的发生率和严重程度（每1000个红细胞中碎片化红细胞的数量以百分比表示）。血吸虫病被分为轻度（<1%）、中度（1-1.9%）或重度（大于或等于2%）。第14天99%(0.1-3.0%，中位数0.4%)，第28天97%(0.1-3.2%，中位数0.4%)，第42天98%（0.1-4.3%，中位数0.5%）可见血吸虫细胞。9例患者（10%）有严重骨折，20例患者（22%）有中度骨折。不同天数间的破碎程度差异不显著。同种异体bmt在第28天（P = 0.008）和第42天（P = 0.02）比自体移植更广泛地碎裂。年龄、调理方案和诊断无影响。移植后随访6个月，所有患者均未发生血栓性微血管病变。偶尔出现轻度溶血的临床和实验室特征的患者对体液平衡和环孢素剂量的调整反应良好。我们的数据表明，轻微的红细胞碎裂是移植后常见的形态学发现，在没有其他临床和实验室结果提示血栓性微血管病变的情况下，没有临床意义，尽管中度或重度碎裂的患者应该密切监测。
Red cell fragmentation is often the earliest sign of thrombotic microangiopathy. Days +14, +28 and +42 blood films from 58 allograft and 32 autograft recipients were reviewed blind to determine the incidence and severity of schistocytosis (the number of fragmented red cells per 1000 red cells expressed as a percentage). Schistocytosis was graded as mild (<1%), moderate (1–1.9%) or severe (⩾2%). schistocytes were seen in 99% of day 14 films (0.1–3.0%, median 0.4%), 97% of day 28 films (0.1–3.2%, median 0.4%), and 98% of day 42 films (0.1–4.3%, median 0.5%). nine patients (10%) had severe fragmentation and 20 patients (22%) had moderate fragmentation at some time or the other. the difference in the extent of fragmentation between the days was not significant. allogeneic bmt was associated with more extensive fragmentation than autologous transplantation on day 28 (P = 0.008) and day 42 (P = 0.02). Age, conditioning regimen and diagnosis had no influence. None of the patients followed-up for 6 months after transplant developed full-blown thrombotic microangiopathy. The occasional patient showing mild clinical and laboratory features of hemolysis responded well to adjustment of fluid balance and cyclosporine dose where applicable. Our data indicate that mild red cell fragmentation is a common morphologic finding after transplantation with no clinical significance in the absence of other clinical and laboratory findings suggestive of thrombotic microangiopathy, although patients with moderate or severe fragmentation should be monitored closely.
骨髓移植后溶血性尿毒症综合征。
影响因子：
4.8
作者：
Juckett,M;Perry,EH;Daniels,BS;Weisdorf,DJ
通讯作者：
Weisdorf,DJ
成人骨髓移植后治疗血液系统恶性肿瘤的溶血尿毒症综合征。
影响因子：
20.3
作者：
Rabinowe,SN;Soiffer,RJ;Tarbell,NJ;Neuberg,D;Freedman,AS;Seifter,J;Blake,KW;Gribben,JG;Anderson,KC;Takvorian,T
通讯作者：
Takvorian,T