造血干细胞移植后出血性膀胱炎的观察

目的:探讨常规预防方案干预下,造血干细胞移植后出血性膀胱炎(hemorrhagiccystitis,HC)的发病情况、危险因素和有效的防治方法。方法:62例恶性血液病患者(自体移植32例,异基因移植30例),移植过程中均进行常规的HC和移植物抗宿主病(graftversushostdisease,GVHD)预防。分析移植后HC发生的特点及与移植类型、其他临床特征的关系和防治效果。结果:共6例发生HC(9.68%),均为异基因移植患者。平均发病时间为46.50天,平均病程为42.50天。4例发生巨细胞病毒(cytomegalovirus,CMV)感染,其中3例合并GVHD,另有1例仅出现GVHD。经治疗后3例完全缓解,2例部分缓解,1例行膀胱切除术。结论:在采取充分的预防措施后,HC多为晚期发生,可能与异基因移植、GVHD和CMV感染有关,病程迁延、部分难治。

Study on hemorrhagic cystitis in patients undergoing hematopoietic stem cell transplantation

Objective: To explore the characteristics,risk factors,effective prevention and treatment of hemorrhagic cystitis (HC) in patients after hematopoietic stem cell transplantation(HSCT) receiving routine prophylaxis for HC. Methods: Sixty-two patients with hemotologic malignancies after HSCT including 32 cases of auto-HSCT and 30 allo-HSCT, were studied. The relationship between HC and transplantation type or other clinical features was analyzed. The curative effect was observed. Results: Six out of 62 (9.68%)patients developed HC. All of them were patients after allo-HSCT. The average time of onset and the average duration was 46.50 days and 42.50 days respectively. Of 4 patients infected with Cytomegalovirus(CMV),three presented with graft versus host disease(GVHD). One patient suffered from GVHD without in fiction of CMV. After treatment, three of them had complete remission, two of them had partial remission, and one patient had a cystotomy at last. Conclusion: After full prevention, most HC are late-onset and long-lasting. which may be related to allo-SCT, CMV infection and GVHD.