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

发布时间：2018-04-18 13:47

本文选题：重型再生障碍性贫血 + 异基因造血干细胞移植　；参考：《解放军医学杂志》2017年12期

【摘要】：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。
[Abstract]:Objective to investigate the clinical features of pulmonary invasive fungal infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with severe aplastic anemia (SAA).Methods Thirty SAA patients treated with allogeneic hematopoietic stem cell transplantation from January 2012 to January 2015 in 307 Hospital of PLA were retrospectively analyzed. All patients were treated with combined transplantation of bone marrow and peripheral blood stem cells.The occurrence, treatment and outcome of pulmonary invasive fungal infection were analyzed after transplantation.Results there were 6 cases of pulmonary invasive fungal infection, the incidence was 20. There were 4 males and 2 females, aged 642 years with an average age of 18.3 years.3 cases were diagnosed by bronchoscopic pathology or sputum fungus culture, 3 cases were diagnosed by imaging and clinical manifestation.Four cases were cured, 2 cases died and the total mortality was 33.3% after first-line antifungal therapy.Conclusion the incidence and mortality of invasive fungal infection after allogeneic hematopoietic stem cell transplantation in patients with severe SAA are high and should be treated with empirical antifungal therapy as soon as possible.
【作者单位】：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;解放军307医院全军造血干细胞研究所;
【分类号】：R519;R556.5

【相似文献】