异基因造血干细胞移植术后嗜酸细胞增高临床意义

The research for clinical significance of eosinophilia in peripheral blood after allogeneic stem cell transplantation

目的:本文回顾性分析了2001年7月至2010年3月在广东省人民医院接受异基因造血干细胞移植资料齐全的161例患者外周血嗜酸细胞的变化,旨在探讨移植后嗜酸细胞增高的危险因素及其临床意义。方法:评估异基因造血干细胞移植术后患者外周血嗜酸细胞的数量,超过0.5×109/L者定义为嗜酸细胞增高。结果:移植后有57例患者出现外周血嗜酸细胞增高,HLA不全相合是发生嗜酸细胞增高的危险因素(P=0.001)。Ⅱ-Ⅳ度急性移植物抗宿主病(GVHD)(P=0.012)、慢性GVHD(P=0.001)是引起嗜酸细胞增高的高危因素。发生嗜酸细胞增高的患者移植后2年总生存率为85.9%,明显高于未发生嗜酸细胞增高患者(44.2%,P<0.001)。结论:外周血嗜酸细胞增高是异基因造血干细胞移植术后的常见并发症,其发生与Ⅱ-Ⅳ度急性GVHD及慢性GVHD有关,是评估患者预后的有效指标。

Objective The aim of study to investigate the change of eosinophi in peripheral blood in 161 patients who received allogeneic hematopoietic stem eel1 transplantation, and to analyze the risk factors and clinical value of eosinophilia. Method Eosinophi in peripheral blood was evaluated after allogeneie hematopoietic stem cell transplantation. Eosinophilia was defined as eosinophil counts more than 0.5 × 109/L. Result The incidence rate of eosinophilia was 35.4% （57/161）. The HLA-incomplete match was found as the risk factor for eosinophilia. II-IV acute GVHD and chronic GVHD were associated with the development of eosinophilia. The two-year survival of patients with eosinophilia was 85.9%, which was higher than that without eosinophilia （P 〈 0.001 ）. Conclusion Eosinophilia in peripheral blood was common complication after Allo-HSCT. Eosinophilia was associated with II -IV acute GVHD and chronic GVHD and might be a marker to predict outcome after Allo-HSCT.