Objective: To investigate the incidence and clinical features to probe the risk factors of hemorrhagic cystitis (HC) in children and adolescents with hematological diseases post haplo-hematopoietic stem cell transplantation (haplo-HSCT) . Methods: Medical records of 62 children and 27 adolescents with hematological diseases treated with haplo-HSCT between 2015 and 2016 were analyzed. Results: Of 89 cases (56 boys and 33 girls) , 44 patients were diagnosed with ALL, 33 AML, 3 AHL and 9 MDS. HC occurred in 32 of the 89 patients with an incidence of 36%, including 6 with grade Ⅰ, 16 with grade Ⅱ, 8 with grade Ⅲ, 2 with grade Ⅳ HC, respectively. The median time of HC onset was 25 days (range 2-55 days) after haplo-HSCT with the median duration as 19 days (range 3-95 days) , all of them were cured. The incidence of HC was lower in the group of children than that in the group of adolescents (27.4% vs 55.6%, χ(2)=6.466, P<0.05) , and the incidence of HC was higher in the group of patients who were ≥5 years old than that in the group of patients who were <5 years old (0 vs 34%, χ(2)=4.043, P<0.05) . Conclusion: HC is one of common complications in children and adolescents with hematological diseases post haplo-HSCT, older age was associated with increased mortality.
目的: 观察儿童及青少年血液病患者单倍型造血干细胞移植(haplo-HSCT)后出血性膀胱炎(HC)的临床特征并探讨其影响因素。 方法: 回顾性分析2015至2016年接受haplo-HSCT的89例儿童及青少年血液病患者的临床资料。 结果: 全部89例患者中,≤14岁62例(儿童组)、>14~<18岁27例(青少年组);男56例,女33例;中位移植年龄10(1~17)岁;急性淋巴细胞白血病(ALL)44例,急性髓系白血病(AML)33例,急性混合细胞白血病(AHL)3例,骨髓增生异常综合征(MDS)9例。移植物来源均为骨髓+外周血干细胞。全部89例患者中32例(36%)发生HC,其中迟发型31例,早发型1例;Ⅰ度6例、Ⅱ度16例、Ⅲ度8例、Ⅳ度2例;HC发病中位时间为移植后25(2~55)d,中位持续时间为19(3~95)d;所有患儿均获得治愈。儿童组HC发病率低于青少年组[27.4%(17/62)对55.6%(15/27),χ(2)=6.466,P<0.05]。儿童组中<5岁组HC发生率低于5~14岁组[0(0/12)对34%(17/50),χ(2)=4.043,P<0.05]。 结论: HC是儿童及青少年血液病患者haplo-HSCT的常见并发症,总体预后良好,年龄是其发生的影响因素。.
Keywords: Haplo-hematopoietic stem cell transplantation; Hemorrhagic cystitis; Risk factors.