【造血干细胞移植后红细胞增多3例报告并文献复习】。

L L Qin, X D Mo, T T Han, W Han, X J Huang, L P Xu
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引用次数: 0

摘要

本文报告三例男性患者。其中一名患者患有骨髓增生异常综合征,两名患有再生障碍性贫血;他们的年龄分别为28岁、32岁和21岁。2例患者接受同胞异基因造血干细胞移植,1例患者接受单倍体造血干细胞移植。所有患者在移植后6、16、9个月血红蛋白和红细胞压积升高,白细胞和血小板正常,未见脾肿大。所有继发性红细胞增多症的病因均已排除。骨髓形态未见红系增生。BCR-ABL (P210、P230、P190及变体)PCR结果均为阴性,JAK2的617氨基酸位点、JAK2的12外显子、CALR的9外显子、MPL的515氨基酸位点均未发现突变。3例患者均有高血压。1例患者用氨氯地平治疗,另外2例患者用血管紧张素受体阻滞剂治疗。3例患者红细胞增多持续时间分别为6年3个月、4年7个月、5年3个月,截止2022年12月。没有自发缓解的倾向。造血干细胞移植后的红细胞增多症是一种罕见的并发症。以往的文献报道表明,异基因造血干细胞移植受者移植后红细胞增多的机制可能与其他移植受者不同。
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[Erythrocytosis after hematopoietic stem cell transplantation: report of 3 cases and literature review].

This is a report of three cases of three male patients. One of the patients had myelodysplastic syndrome, and two had aplastic anemia; their ages were 28, 32, and 21 years old, respectively. Two patients underwent sibling allogeneic hematopoietic stem cell transplantation, and one underwent haploidentical hematopoietic stem cell transplantation. All the patients showed elevated hemoglobin and hematocrit at 6, 16, and 9 months after transplantation, with normal white blood cells and platelets and no splenomegaly. All causes of secondary polycythemia were ruled out. Bone marrow morphology showed no erythroid hyperplasia. The PCR result for BCR-ABL (P210, P230, P190, and variants) was negative, and there were no mutations at the amino acid site 617 of JAK2, exon 12 of JAK2, exon 9 of CALR, and amino acid site 515 of MPL. All three patients had hypertension. One patient was treated with amlodipine, and the other two patients were treated with angiotensin receptor blockers. The durations of erythrocytosis for these three patients were 6 years and 3 months, 4 years and 7 months, and 5 years and 3 months, respectively through December 2022. There was no tendency for spontaneous remission. Erythrocytosis after hematopoietic stem cell transplantation is a rare complication. Previous reports in the literature suggest that the mechanism of post-transplant erythrocytosis in recipients of allogeneic hematopoietic stem cell transplantation may be different from that of recipients of other transplants.

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