肺移植治疗八例造血干细胞移植后闭塞性细支气管炎综合征的临床分析

Clinical analysis of lung transplantation in eight patients with obstructive bronchiolitis syndrome after hematopoietic stem cell transplantation

目的探讨肺移植治疗异基因造血干细胞移植（allo．HSCT）后闭塞性细支气管炎综合征（BOS）终末期的疗效。方法回顾性分析8例肺移植治疗allo-HSCT后BOS终末期病例的临床资料。结果8例患者均因血液系统恶性肿瘤行allo—HSCT，allo-HSCT时中位年龄为23（12—40）岁，供者为父母或同胞兄弟姐妹。8例患者allo—HSCT后发生严重BOS，行肺移植时的中位年龄为27．5（13-47）岁。allo—HSCT和肺移植的中位间隔时间是69（21—132）个月。中位随访时间为15（6～63）个月，7例存活，1例患者肺移植术后15个月死于肺出血。存活患者中有3例再发BOS，其中1例再次行肺移植术并获得成功。结论肺移植术是治疗allo．HSCT后BOS终末期患者的一种有效手段。

Objective To investigate the efficacy and prognosis of lung transplantation （LT） for end-stage bronchiolitis obliterans syndrome （BOS） after allogeneic hematopoietic stem cell transplantation （allo-HSCT）. Methods The clinical data of eight cases with end-stage BOS after allo-HSCT who were treated by LT in our hospital were retrospectively analyzed. Results Eight patients with hematological malignancy underwent allo-HSCT, and the median age was 23 （12-40） years. The donors are parents or siblings. Severe BOS occurred in 8 patients after allo-HSCT, the median age for LT was 27.5 （13-47） years. The median interval between allo-HSCT and LT was 69 （21-132） months. The median follow-up time for 8 patients after LT was 15 （6-63） months, 7 patients survived, 1 patient died of pulmonary hemorrhage 15 months after LT treatment.-Of the survivors, three had BOS again, and one of them received reduplicated lung transplantation. Conclusion LT is an effective treatment for patients with severe BOS after HSCT.