摘要
目的探讨肝移植术后急性白血病的临床特征和危险因素。方法中山大学附属第三医院肝脏移植中心报道首例肝移植术后急性粒细胞白血病部分分化型(AML-M2)诊疗经过和化疗过程中免疫抑制剂的应用经验。通过文献复习,对其临床特点和预后进行分析。结果 1例42岁男性病人在肝移植术后38个月被确诊为急性白血病,经过适当的免疫抑制剂调整使其安全度过化疗期并获得缓解。复习相关文献肝移植术后发生急性白血病病人17例,1年以内的病死率高达52.94%。结论肝移植术后急性白血病是一种少见但病死率极高的并发症,病人染色体变异类型、免疫抑制剂的使用及肝炎病毒的感染可能和肝移植术后急性白血病死亡有关。
Objective Acute leukemia is a rare complication after liver transplantation （LT）. Identifing the clinical characteristics and risk factors will improve the diagnosis and treatment level and survival rate of acute leukemia after LT. Methods The first case of AML-M2 patients who underwent LT at Transplant Center, the Third Affiliated Hospital of Sun Yat-sen University was reported. The process of diagnosis, treatment and experiences on adjustment immunodepressant during chemotherapy were introduced. The clinical characteristics and risk factors were analyzed based on review of the literature on similar cases. Results The patient, a 42-year-old man who developed acute leukemia 38 months after liver transplantation, was treated by chemotherapy successfully and had been in continuous remission subsequently with appropriate adjustment of immunosuppressive agents. Only 17 patients with acute leukemia after LT had been reported, but the mortality rate （52.94%） was high extraordinarily within 1 year. Conclusion Acute leukemia is a rare and fatal complication after LT. The patient＇ s chromosomal mutation profile, the choice of immunodepressant and infection by hepatitis virus may be the reasons for death of acute leukemia after LT.
出处
《中国实用外科杂志》
CSCD
北大核心
2010年第11期946-948,共3页
Chinese Journal of Practical Surgery
基金
国家重点基础研究发展计划(973计划)(No.2009CB522404)
十一五科技重大专项课题(No.2008ZX10209)
广东省科技计划项目重大专项(No.2007A032000001)
2007-2009年度卫生部部属(管)医院临床学科重点项目
关键词
急性白血病
肝移植
感染
acute leukemia
liver transplantation
infection
