重型再生障碍性贫血免疫抑制治疗后并发淋巴瘤2例报告及文献复习

目的:通过报告2例重型再生障碍性贫血(再障)进行抗人T细胞免疫球蛋白(ATG)加环孢素(CsA)为主的免疫抑制治疗后并发非霍奇金淋巴瘤的病例,结合文献复习,提高对重型再障免疫抑制治疗后并发淋巴增殖性疾病的认识。方法:针对此2例患者进行了病例分析及相关文献复习。结果:2例患者分别在行ATG加CsA为主的免疫抑制治疗后6个月及8个月并发肠道B细胞非霍奇金淋巴瘤,出现不全肠梗阻。其中1例有免疫抑制治疗后病毒感染史,并发淋巴瘤后行CHOP方案化疗,病情好转;另1例无病毒感染史,手术后死于肺部感染。结论:重型再障经免疫抑制治疗后可并发淋巴增殖性疾病,其发生与免疫抑制应用及病毒感染有关,病因及病理与移植后淋巴增殖性疾病相似,是重型再障进行免疫抑制治疗的一种严重并发症。

Lymphoma occurred following severe aplastic anemia treated with immunosuppressive therapy:2 cases report and literature review

Objective:To improve the understanding of the lymphoproliferative disorders occurred following severe aplastic anemia (AA) treated with immunosuppressive therapy.Method:2 patients with lymphoma occurred following severe AA treated with anti-thymocyte globulin (ATG) and cyclosporine (CSA) were analyzed and related literatures were reviewed.Result:B cell non-hodgkin lymphoma in intestinal tract accompanied by uncompleted intestinal obstruction was diagnosed at 6th and 8th month respectively after the initial treatment with the combination of ATG and CSA. One patient with a preceding virus infection history received CHOP regimen and got better,the other patient,without virus infection history,died of pulmonary infection after operation.Conclusion:Lmphoproliferative disorders,related to immunosuppressive agent and virus infection,may occur in severe AA patients after the immunosuppressive treatment and may be the grave complication in this type of patients.