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首页> 外文期刊>British Journal of Haematology >Incidence and natural history of pure red cell aplasia in major ABO-mismatched haematopoietic cell transplantation
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Incidence and natural history of pure red cell aplasia in major ABO-mismatched haematopoietic cell transplantation

机译：主要ABO不匹配的造血细胞移植中纯红细胞发育不全的发生率和自然史

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Major ABO mismatching is not considered a contraindication to allogeneic haematopoietic stem cell transplantation (HSCT). Modern reduced-intensity conditioning and reduced-toxicity regimens cause much less myeloablation than conventional myeloablative regimens, such as cyclophosphamide with busulfan or total body irradiation, which may affect the incidence of pure red cell aplasia (PRCA). We estimated the incidence and described the natural history of PRCA in patients with major ABO-mismatched donor stem cells. Between 2007 and 2008, 161 (27% of all patients undergoing HSCT) underwent allogeneic HSCT with major ABO-mismatched stem cells and 12 (7??5%) of these patients developed PRCA. Thirty and ninety day T-cell and myeloid cell chimerism and neutrophil and platelet engraftment did not differ between patients who developed PRCA and those who did not. The only risk factor associated with PRCA was the use of a fludarabine/busulfan conditioning regimen. All patients with PRCA needed red cell transfusion for several months after HSCT resulting in significant iron overload. Pure red cell aplasia resolved spontaneously in the majority (seven patients) but only resolved after stopping tacrolimus in three patients. Hence, after major ABO-mismatched HSCT, the incidence of PRCA was 7??5% and it resolved spontaneously or after withdrawal of immunosuppression in the majority of patients. ? 2013 Blackwell Publishing Ltd.
机译：严重的ABO错配不被视为异基因造血干细胞移植（HSCT）的禁忌症。与传统的清髓疗法相比，现代的低强度调理和低毒性疗法所产生的清髓效果要低得多，例如环磷酰胺联合环丁砜或全身照射，这可能会影响纯红细胞发育不全（PRCA）的发生。我们估算了主要ABO不匹配供体干细胞患者的PRCA发病率并描述了其自然病史。在2007年至2008年之间，有161名（占所有接受HSCT的患者的27％）接受了具有主要ABO不匹配干细胞的同种异体HSCT，其中12名（占7％5％）的患者患有PRCA。发生PRCA的患者与未发生PRCA的患者，第30天和第90天的T细胞和髓样细胞嵌合以及嗜中性粒细胞和血小板植入没有差异。与PRCA相关的唯一危险因素是使用氟达拉滨/白消安调理方案。所有HSCA患者在HSCT后需要输血数月，导致大量铁超载。多数（七名患者）自发性纯红细胞发育不良，但三名患者停止他克莫司后才消退。因此，在大多数ABO不匹配的HSCT后，PRCA的发生率为75％，并且在大多数患者中自发消退或撤消免疫抑制后。 ？ 2013布莱克威尔出版有限公司

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