单倍体相合非清髓造血干细胞移植治疗恶性血液病术后中枢神经系统并发症

The central nervous system complications after hapilo-matched non-ablative peripheral blood hematopoietic stem cells transplantation for malignant hematological disease

目的 分析单倍体相合非清髓造血干细胞移植治疗恶性血液病术后1年中枢神经系统并发症的临床特点、可能的危险因素及预后.方法 对2004年2月至2009年5月收治的36例进行单倍体相合非清髓造血干细胞移植的恶性血液病患者进行回顾性研究.结果 有6例患者出现中枢神经系统并发症,发生率16.7%,死亡4例,病死率66.7%,其中脑梗死3例（8.3%）,脑软化2例（5.6%）,颅内出血1例（2.8%）,癫痫1例（2.8%）.移植后中枢神经系统并发症发生最短时间12 d,最长时间286 d.患者年龄、疾病状态、病死率与未发生中枢神经系统并发症的移植患者差异有统计学意义（P＜0.05）.结论 单倍体相合非清髓造血干细胞移植治疗恶性血液疾病,中枢神经系统并发症的发生率和病死率较高,直接影响患者的生活质量和预后,疾病状态、年龄偏大可能是其危险因素.

Objective To explore the incidence ,clinical and neuroimaging features, possible risk factors and outcome of central nervous system （CNS） complications one year after hapilo-matched non-ablative hematopoietic stem cells transplantation. Methods The medical records of 36 consecutive patients who underwent hapilo-matched non-ablative hematopoietic stem cells transplantation for malignant and nonmalignant hematologic diseases between February 2004 and May 2009 were reviewed. Results CNS complications occurred in six （16.7 %） patients. Four of the six patients （66.7 %） died. Cerebral infarction occurred in three （8.3 %） patients. Cerebral softenness occurred in two （5.6 %） patients. Cerebral hemarrage occurred in 1 （2.8 %） patient. Epilepsy occurred in 1 （2.8 %） patient. The CNS complications occurred between 12 days and 286 days after stem cells transplantation. The age illness status and death rate were statistically different compared to patients without CNS complications （P 〈0.05）. Conclusion The incidence and mortality of CNS complications are higher in those who underwent hapilo-matched non-ablative hematopoietic stem cells transplantation,which will make impacts on the patients＇ life quality and outcome.The illness status and eldly are probably the risk factors.