[同种异体造血干细胞移植后 20 例肺孢子虫肺炎患者的临床特征]。

Q3 Medicine
R Ma, S T Chang, X D Mo, M Lyu, Y Wang, X H Zhang, L P Xu, X J Huang, Y Q Sun
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引用次数: 0

摘要

本研究纳入了2014年4月至2022年10月期间在北京大学人民医院接受异基因造血干细胞移植(allo-HSCT)后发生肺孢子菌肺炎(PJP)的20例血液病患者。20例患者中有13例男性(65.0%)和7例女性(35.0%),中位年龄为34(19-60)岁。其中急性髓细胞白血病 11 例(55.0%),急性淋巴细胞白血病 4 例(20.0%),骨髓增生异常综合征 2 例(10.0%),慢性粒细胞白血病 1 例(5.0%),非霍奇金淋巴瘤 1 例(5.0%),再生障碍性贫血 1 例(5.0%)。3 例(15.0%)HLA 相同的同胞造血干细胞移植,3 例(15.0%)匹配的非亲属捐献者造血干细胞移植,14 例(70.0%)单倍体造血干细胞移植。PJP的中位发病时间为移植后353(74-1121)天。临床症状主要包括发热、咳嗽、排痰和呼吸困难。根据 CT 扫描结果,所有患者都有感染迹象,包括双侧弥漫性磨玻璃不透明、斑片状阴影和实性结节。九名患者(45.0%)需要通过鼻导管氧气吸入进行呼吸支持,七名患者(35.0%)需要呼吸机辅助呼吸。有 7 名患者(35.0%)出现严重感染,13 名患者(65.0%)出现轻度至中度感染。此外,8 名患者(40.0%)并发巨细胞病毒感染,2 名患者并发 EB 病毒感染。此外,所有 20 名患者都接受了复方磺胺甲噁唑治疗(标准剂量 11 例;低剂量 9 例)。此外,19 名患者存活,1 名患者死亡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Clinical features of 20 cases with Pneumocystis jirovecii pneumonia after allogeneic hematopoietic stem cell transplantation].

This study included 20 patients with hematological diseases who developed Pneumocystis jirovecii pneumonia (PJP) after receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT) from April 2014 to October 2022 at Peking University People's Hospital. The 20 patients comprised 13 males (65.0% ) and seven females (35.0% ), with a median age of 34 (19-60) years. Eleven cases (55.0% ) of acute myeloid leukemia, four cases (20.0% ) of acute lymphocytic leukemia, two cases (10.0% ) of myelodysplastic syndrome, one case (5.0% ) of chronic myelomonocytic leukemia, one case (5.0% ) of non-Hodgkin lymphoma, and one case (5.0% ) of aplastic anemia were analyzed. Three cases (15.0% ) of HLA-identical sibling hematopoietic stem cell transplantation, three cases (15.0% ) of matched unrelated donor hematopoietic stem cell transplantation, and 14 cases (70.0% ) of haploid hematopoietic stem cell transplantation were identified. The median onset time of PJP was 353 (74-1121) days after transplantation. The clinical symptoms mainly included fever, cough, expectoration, and dyspnea. All patients presented signs of infection based on the CT scan, including bilateral diffuse ground-glass opacities, patchy shadows, and solid nodules. Nine patients (45.0% ) required respiratory support via nasal catheter oxygen inhalation, while seven patients (35.0% ) required ventilator-assisted breathing. Seven (35.0% ) severe infections and 13 (65.0% ) mild to moderate infections were recorded. Moreover, eight patients (40.0% ) were complicated with human cytomegalovirus infection, whereas two patients were complicated with EB virus infection. Furthermore, all 20 patients received treatment with compound sulfamethoxazole (standard dose, 11 cases; low dose, 9 cases). Furthermore, 19 patients survived and one patient died.

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