“红细胞预灌注法”联合“立减递增提速法”白细胞去除术治疗高白细胞性白血病并中重度贫血的临床研究
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摘要
目的:探索"红细胞预灌注法"联合"立减递增提速法"白细胞去除术治疗高白细胞性白血病并中、重度贫血的有效性及安全性。方法:对照组应用"立减递增提速法"白细胞去除术;治疗组应用红细胞2~3 U预灌注白细胞管道后再连接血管运行,其余操作同对照组。结果:两组都能有效清除白细胞;治疗组"急性失血"症状发生率低于对照组,差异有统计学意义。结论:"红细胞预灌注法"联合"立减递增提速法"白细胞去除术能有效清除白血病细胞,并能降低"急性失血"症状的发生率,值得临床推广应用。
Objective: To study the efficacy and safety of pre-transfusion of red blood cells combined with improved-leukapheresis in the treatment of hyperleucocytic leukemia with moderate or severe anemia. Methods: Patients in the control group were treated with improved-leukapheresis,while patients in the trial group underwent pre-transfusion of 2 ~ 3 U red blood cells followed by improved-leukapheresis. Results: Leukocytes in both of the two groups decreased significantly after leukapheresis; symptoms related to acute hemorrhage occurred with a lower incidence in the trial group,compared with that in the control group. Conclusion: Therapy with pre-transfusion of red blood cells followed by improved-leukapheresis can not only deplete leukocytes effectively but also reduce the incidence of side effects associated with acute hemorrhage significantly.
Objective: To study the efficacy and safety of pre-transfusion of red blood cells combined with improved-leukapheresis in the treatment of hyperleucocytic leukemia with moderate or severe anemia. Methods: Patients in the control group were treated with improved-leukapheresis,while patients in the trial group underwent pre-transfusion of 2 ~ 3 U red blood cells followed by improved-leukapheresis. Results: Leukocytes in both of the two groups decreased significantly after leukapheresis; symptoms related to acute hemorrhage occurred with a lower incidence in the trial group,compared with that in the control group. Conclusion: Therapy with pre-transfusion of red blood cells followed by improved-leukapheresis can not only deplete leukocytes effectively but also reduce the incidence of side effects associated with acute hemorrhage significantly.
引文
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[11]Jiang ML,Zhang JL,Li XJ.Effect of leukapheresis combined with chemotherapy in the treatment of hyperleukocytic leukemia[J].J Qilu Nursing,2002,8(10):741-742.[姜美玲,张景莲,李晓娟.白细胞去除术加联合化疗治疗高白细胞白血病疗效观察[J].齐鲁护理杂志,2002,8(10):741-742.]
[2]Luo ZM,Zhou XF,Li JY,et al.Effect of improved leukapheresis on patients with hyperleukocytic leukemia[J].J Clin Hematol(China),2013,26(9):635-641.[罗自勉,周新伏,李佳元,等.改良法白细胞去除术治疗高白细胞性白血病的临床研究[J].临床血液学杂志,2013,26(9):635-641.]
[3]Zhang ZN.Standard for diagnosis and therapeutic effect of hematopathy[M].Beijing:The Science Publishing Company,2007:232-234.[张之南.血液病诊断及疗效标准[M].北京:科学出版社,2007:232-234.]
[4]Ruggiero A,Rizzo D,Amato M,et al.Management of hyperleukocytosis[J].Curr Treat Options Oncol,2016,17(2):7.
[5]Lu ZY.Internal medicine[M].Beijing:People's Medical Publishing House,2010:605.[陆再英.内科学[M].北京:人民卫生出版社,2010:605.]
[6]Wang M,Wang LR.Hyperleukocytic leukemia:A state-of-theart overview[J].Chin J of Practical Internal Med,2011,31(4):298-299.[王敏,王立茹.高白细胞性白血病研究现状[J].中国实用内科学杂志,2011,31(4):298-299.]
[7]Cai C,Chen ZW.Clinical application of blood cell separator in hyperleukocytic acute leukemia[J].Chin J Blood Transfusion,2012,25(2):26-27.[蔡蔡,陈焯文.血细胞分离机对高白细胞急性白血病的临床应用[J].中国输血杂志,2012,25(2):26-27.]
[8]Meng GQ,Wang LR,Chen YJ,et al.Clinical application of leukapheresis in patients with hyperleukocytic acute leukemia[J].J Capital Med University,2014,35(5):565-571.[孟广强,王立茹,陈以娟,等.白细胞分离术在高白细胞急性白血病中的临床应用[J].首都医科大学学报,2014,35(5):565-571.]
[9]Wu Y,Wu YJ,Li HS,et al.Clinical research:Evaluation of the effectiveness of continuous flow centrifuge and blood component separator on the reduction therapy of leukocytes[J].Chin J Blood Transfusion,2015,28(1):45-48.[吴勇,吴远军,李惠森,等.连续流动离心式血液成分分离机高量减除白细胞治疗的采集效果评价[J].中国输血杂志,2015,28(1):45-48.]
[10]Huang JY,Deng H,Gao XH,et al.Leukapheresis in the treatment of patients with hyperleukocytic acute leukemia[J].Guangdong Med J,2002,23(9):928-929.[黄建云,邓晖,高小华,等.白细胞单采术在高白细胞白血病治疗中的应用[J].广东医学杂志,2002,23(9):928-929.]
[11]Jiang ML,Zhang JL,Li XJ.Effect of leukapheresis combined with chemotherapy in the treatment of hyperleukocytic leukemia[J].J Qilu Nursing,2002,8(10):741-742.[姜美玲,张景莲,李晓娟.白细胞去除术加联合化疗治疗高白细胞白血病疗效观察[J].齐鲁护理杂志,2002,8(10):741-742.]