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自体造血干细胞移植相关肝损伤的临床研究[J]. 肿瘤防治研究, 2013, 40(04): 359-361. DOI: 10.3971/j.issn.1000-8578.2013.04.010
引用本文: 自体造血干细胞移植相关肝损伤的临床研究[J]. 肿瘤防治研究, 2013, 40(04): 359-361. DOI: 10.3971/j.issn.1000-8578.2013.04.010
Clinical Study of Liver Injury Associated with Autologous Hematopoietic Stem Cell Transplantation[J]. Cancer Research on Prevention and Treatment, 2013, 40(04): 359-361. DOI: 10.3971/j.issn.1000-8578.2013.04.010
Citation: Clinical Study of Liver Injury Associated with Autologous Hematopoietic Stem Cell Transplantation[J]. Cancer Research on Prevention and Treatment, 2013, 40(04): 359-361. DOI: 10.3971/j.issn.1000-8578.2013.04.010

自体造血干细胞移植相关肝损伤的临床研究

Clinical Study of Liver Injury Associated with Autologous Hematopoietic Stem Cell Transplantation

  • 摘要: 目的 探讨自体造血干细胞移植相关肝损伤的临床特点。 方法 回顾性分析109例接受自体造血干细胞移植的淋巴瘤患者的临床资料。 结果 109例淋巴瘤患者接受预处理方案化疗后,肝脏生化学的异常改变主要是氨基转移酶、总胆红素的升高,其中30.3%出现丙氨酸氨基转移酶升高,14.7%出现天门冬氨酸氨基转移酶升高,11.0%出现总胆红素升高,Ⅲ~Ⅳ度肝损伤的发生率仅为1.8%。与CBV方案比较,BEAM方案更可能导致总蛋白降低、白蛋白/球蛋白比值异常、总胆红素和间接胆红素升高。10例HBsAg阳性的淋巴瘤患者给予拉米夫定预防治疗,均未发生乙型肝炎病毒再激活。 结论 自体造血干细胞移植治疗淋巴瘤相关重度肝损伤的发生率低,合并乙型肝炎病毒感染者给予拉米夫定预防治疗可以有效防止乙型肝炎病毒再激活。

     

    Abstract: Objective To explore the clinical characteristics of liver injury associated with autologous hematopoietic stem cell transplantation for lymphoma. Methods Clinical data of 109 lymphoma patients was collected and analyzed retrospectively,who were treated with autologous hematopoietic stem cell transplantation. Results Among these patients who received hematopoietic stem cell transplantation,the main abnormal parameters of liver function were the increased levels of aminotransferase and total bilirubin.Increased alanine aminotransferase accounted for 30.3%,increased aspartate aminotransferase 14.7%,increased total bilirubin 11.0%,and the rate of grade Ⅲ-Ⅳ liver injury was only 1.8%.Compared with CBV conditioning regimen,BEAM regimen was more likely to lead to decreased total protein,abnormal albumin/globulin ratio,and increased total bilirubin and indirect bilirubin.Ten cases of HBsAg-positive lymphoma were treated with lamivudine prophylaxis and no hepatitis B virus reactivation occurred. Conclusion Severe liver injury associated with autologous hematopoietic stem cell transplantation for lymphoma is in low probability.Furthermore,hepatitis B virus reactivation could be prevented using lamivudine prophylaxis in lymphoma patients with hepatitis B virus infection.

     

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