[8例接受异体造血干细胞移植的肝腺瘤患者的预后分析]。

Y He, Z L Xu, R Ma, J Liu, Y Y Zhang, M Lyu, X D Mo, C H Yan, Y Q Sun, X Y Zhang, Y Wang, X H Zhang, X J Huang, L P Xu
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引用次数: 0

摘要

目的评估肝腺瘤患者接受异基因造血干细胞移植(allo-HSCT)的安全性。方法对 2010 年 1 月至 2024 年 3 月期间在北京大学人民医院血液科接受异基因造血干细胞移植的 8 例肝腺瘤患者的临床特征和预后进行回顾性分析。结果在接受allo-HSCT的8例肝腺瘤患者中,1例为MDS-h输血依赖型,7例为再生障碍性贫血。患者的中位年龄为 23 岁(13-48 岁)。从诊断出AA或MDS到移植的中位时间为14年(6-24年),而从服用雄激素到诊断出肝腺瘤的中位时间为9年(5-13年)。六例患者接受了单倍体造血干细胞移植,一例患者接受了匹配的非亲缘供体造血干细胞移植,一例患者接受了匹配的亲缘供体造血干细胞移植。所有患者均在单倍体造血干细胞移植后的中位时间11.5天(11-20天)内实现了中性粒细胞移植,在60天内实现了PLT移植,中位时间为19天(10-37天)。此外,7 名患者在移植后出现 CMV 贫血,3 名患者出现出血性膀胱炎,2 名患者出现急性 GVHD。移植期间和移植后,8 名患者未出现严重的肝功能损伤或肝腺瘤破裂。就影像学大小而言,4 名患者的肝腺瘤在移植后有不同程度的缩小,而 4 名患者的肝腺瘤在移植后没有明显变化。中位随访时间为 540.5(30-2989)天。8 名患者中,6 人存活,2 人死亡。此外,未观察到死亡与肝腺瘤之间存在直接关联。结论肝腺瘤患者接受allo-HSCT并非移植禁忌症,也不会增加移植相关死亡率。
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[Prognostic analysis of 8 patients with hepatic adenoma undergoing allogeneic hematopoietic stem cell transplantation].

Objective: To evaluate the safety of patients with hepatic adenoma undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: A retrospective analysis of the clinical characteristics and prognosis of eight patients with hepatic adenoma who underwent allo-HSCT in the Hematology Department of Peking University People's Hospital from January 2010 to March 2024 was conducted. Results: Of the eight patients who underwent allo-HSCT with hepatic adenoma, one patient was considered MDS-h transfusion-dependent and seven had aplastic anemia. The median age of the patients was 23 years (13-48 years). The median time from the diagnosis of AA or MDS to transplantation was 14 years (6-24 years), whereas the median time from taking androgens to diagnosing hepatic adenoma was 9 years (5-13 years). Six cases underwent haplo-HSCT, one case underwent matched unrelated donor HSCT, and one case underwent matched related donor HSCT. All patients achieved neutrophil engraftment at a median time of 11.5 days (11-20 days) and PLT engraftment within 60 days at a median of 19 days (10-37 days) after haplo-HSCT. Moreover, seven patients developed CMV anemia after transplantation, three patients had hemorrhagic cystitis, and two patients developed acute GVHD. During and after transplantation, eight patients did not show severe liver function damage or rupture of hepatic adenoma. In relation to imaging size, four patients showed varying degrees of reduction in hepatic adenoma size after transplantation, whereas four patients did not show significant changes in hepatic adenoma size after transplantation. The median follow-up time was 540.5 (30-2 989) days. Of the eight patients, six survived and two died. Furthermore, no direct correlation was observed between death and hepatic adenoma. Conclusion: Patients with hepatic adenomas undergoing allo-HSCT are not contraindications for transplantation, which will not increase transplant-related mortality.

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