异基因造血干细胞移植术后毛细血管渗漏综合征临床特征及危险因素分析

Clinical Characteristics of and Risk Factors for Capillary Leak Syndrome after Allogeneic Hematopoietic Stem Cell Transplantation

目的分析异基因造血干细胞移植术(allogeneic hematopoietic stem cell transplantation,allo-HSCT)后并发毛细血管渗漏综合征(capillary leak syndrome,CLS)的发生率、危险因素和结局,并探讨其防治措施。方法回顾性分析2005年6月2011年2月住院的allo-HSCT术后14例并发CLS的临床资料。结果 CLS发生率为9.2%(14/152)。年龄、性别、诊断、HLA配型、预处理、CD34+细胞量、粒细胞集落刺激因子(granulocyte colony-stimulatingfactor,G-CSF)用量、植入时间均不能认定为造血干细胞移植后CLS诱发因素。结论 HSCT术后CLS诱因尚不清楚,采用限水、减量G-CSF、使用糖皮质激素和羟乙基淀粉等措施及时治疗,有助于控制CLS。

Objective To study the occurrence rate,risk factors and outcomes of capillary leak syndrome（CLS） after allogeneic hematopoietic stem cell transplantation（allo-HSCT）,and discuss its prevention and treatment.Methods We retrospectively analyzed the clinical records of 14 allo-HSCT recipients complicated with CLS from June 2005 to February 2011.Results Fourteen out of 152 patients developed CLS with a cumulative incidence of 9.2 %.None of the 8 clinical parameters including age,gender,underlying disease,donor type,conditioning regimen,CD34＋ cell dose,granulocyte colony-stimulating factor（G-CSF） dosage,and days to neutrophil engraftment could be identified as risk factors for the occurrence of CLS.Conclusions Risk factors for CLS after allo-HSCT have not been fully established.Restriction of water intake,administration of corticosteroids and hydroxyethyl starch can be beneficial for patients with CLS.