重型再生障碍性贫血移植后合并肺部侵袭性真菌感染6例临床分析

目的探讨重型再生障碍性贫血（SAA）患者行异基因造血干细胞移植（allo-HSCT）后发生肺部侵袭性真菌感染的临床特点。方法回顾性分析解放军307医院2012年1月-2015年1月行异基因造血干细胞移植治疗的30例SAA患者,均采用骨髓加外周血干细胞联合移植,移植后随访分析患者肺部侵袭性真菌感染的发生、治疗和转归。结果共6例患者合并肺部侵袭性真菌感染,发生率20%,其中男4例,女2例,年龄6~42岁,平均年龄18.3岁。患者均有肺部特征性影像学改变,通过支气管镜病理或痰真菌培养确诊3例,通过影像学及临床表现临床诊断3例。应用一线抗真菌治疗后4例治愈,死亡2例,总死亡率33.3%。结论重型SAA...

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Published inJie fang jun yi xue za zhi Vol. 42; no. 12; pp. 1097 - 1101
Main Author 郭智;任骅;胡亮钉;徐晨;李欲航;扈江伟;陈丽萍;陈虎
Format Journal Article
LanguageChinese
Published Beijing People's Military Medical Press 2017
518116广东深圳,国家癌症中心/中国医学科学院北京协和医学院肿瘤医院深圳医院血液淋巴瘤科%100071北京,解放军307医院全军造血干细胞研究所
Subjects
Anemia
Fungal infections
Stem cells
侵袭性真菌感染
异基因造血干细胞移植
肺部
重型再生障碍性贫血
侵袭性真菌感染
异基因造血干细胞移植
invasive fungal infection
severe aplastic anemia
pulmonary
重型再生障碍性贫血
肺部
allogeneic hematopoietic stem cell transplantation
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ISSN0577-7402
DOI10.11855/j.issn.0577-7402.2017.12.14

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Summary:目的探讨重型再生障碍性贫血（SAA）患者行异基因造血干细胞移植（allo-HSCT）后发生肺部侵袭性真菌感染的临床特点。方法回顾性分析解放军307医院2012年1月-2015年1月行异基因造血干细胞移植治疗的30例SAA患者,均采用骨髓加外周血干细胞联合移植,移植后随访分析患者肺部侵袭性真菌感染的发生、治疗和转归。结果共6例患者合并肺部侵袭性真菌感染,发生率20%,其中男4例,女2例,年龄6~42岁,平均年龄18.3岁。患者均有肺部特征性影像学改变,通过支气管镜病理或痰真菌培养确诊3例,通过影像学及临床表现临床诊断3例。应用一线抗真菌治疗后4例治愈,死亡2例,总死亡率33.3%。结论重型SAA患者异基因造血干细胞移植后合并侵袭性真菌感染发生率高,死亡率高,应尽早行经验性抗真菌治疗。
Bibliography:Objective To study the clinical characteristics of pulmonary invasive fungal infection （IFI） in patients with severe aplastic anemia （SAA） after allogeneic hematopoietic stem cells transplantation （allo-HSCT）. Methods The clinical data of 30 SAA patients received allo-HSCT in 307 Hospital of PLA from Jan. 2012 to Jan. 2015 were analyzed retrospectively. All the SAA patients accepted combined bone marrow with peripheral blood stem cells transplantation, and then the clinical features and outcome of pulmonary IFI after transplantation were analyzed. Results Six （20%） of the 30 SAA patients were complicated by IFI after transplantation, including 4 males and 2 females with average age of 18.3（6-42） years. All the 6 patients showed characteristic imaging changes in pulmonary, of which 3 cases were definitely diagnosed by bronchoscopy or sputum fungal culture, and the other 3 cases by imaging and clinical manifestation. Four cases were cured and 2 cases died after first-line antifungal therapy, the total mortality
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ISSN:0577-7402
DOI:10.11855/j.issn.0577-7402.2017.12.14