论文部分内容阅读
目的 分析血液病患者移植前供、受者感染乙型肝炎病毒 (HBV)对造血干细胞移植(HSCT)临床结果的影响。方法 对我院 1986年 10月～ 1998年 12月间进行HSCT前供、受者感染HBV的 2 6例患者临床资料进行回顾性分析。结果 ①移植后 3例患者发生VOD ,发生率 (11.5 % )明显高于供、受者无HBV感染的患者 (1.4% ) (P <0 .0 5 ) ;② 5例输注HBsAg(+)供者造血干细胞患者 2例发生乙型肝炎 ;③ 4例异基因HSCT者发生肝功能衰竭 (LF) ,均发生在异基因移植后环孢菌素A(CsA)减量或停药过程中 ,LF的发生率 (15 .4% )明显高于供、受者未感染HBV的患者 (0 .8% ) (P <0 .0 1) ;④ 4例HBeAg(+)患者中 ,2例异基因HSCT者死于肝功能衰竭 ,而 2例自体HSCT者均生存。结论 供、受者HBV感染不是HSCT的禁忌证 ,但异基因HSCT后CsA减量或停药时有发生LF的危险 ,而HBeAg(+)的患者可能适合进行自体造血干细胞移植。
Objective To analyze the effect of Hepatitis B virus (HBV) infection on the clinical outcome of hematopoietic stem cell transplantation (HSCT) in patients with hematological diseases before transplantation. Methods A retrospective analysis was performed on the clinical data of 26 patients with HBV infected before HSCT from October 1986 to December 1998 in our hospital. Results ① The incidence of VOD in 3 patients after transplantation was significantly higher than that in donor and recipient (1.4%) (P <0. 05) 2 patients with hematopoietic stem cell hematopoietic stem cell hematopoietic stem cell (HBV) developed liver cirrhosis; 4 cases of hepatic failure (LF) occurred in allogeneic HSCT patients, all of which occurred during the reduction or withdrawal of cyclosporin A (CsA) after allogeneic transplantation, The incidence of LF (15.4%) was significantly higher than that of donors (0.8%) (P <0.01); ④ Of the 4 cases of HBeAg (+) patients, 2 cases were different Gene HSCT died of liver failure, while 2 cases of autologous HSCT were survival. Conclusions HBV infection in donors and recipients is not a contraindication to HSCT. However, there is a risk of developing LF when CsA is reduced or discontinued after allogeneic HSCT, whereas patients with HBeAg (+) may be suitable for autologous hematopoietic stem cell transplantation.