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目的研究肠型和极重度骨髓型放射病患者外周造血干细胞移植前后骨髓象的动态变化。方法分别对两例患者的骨髓标本进行常规瑞氏染色,每份样本在显微镜下计数200个有核细胞,分析骨髓各系统各阶段细胞数量和形态学改变。结果病例A(肠型放射病)较病例B(极重度骨髓型放射病)在受照后的骨髓损伤更严重。病例A于半相合移植后+7d,骨髓涂片只找到15个有核细胞,但可见中幼粒细胞,移植+14d后骨髓粒系、红系、巨核系均恢复造血功能,但未见产板巨核细胞。病例B于全相合移植后+7d,骨髓粒、红两系恢复,移植后+14d骨髓三系均恢复,各阶段细胞比值大致在正常范围。结论两例急性放射病患者在受照后骨髓损伤严重,但经半相合和全相合的外周血造血干细胞移植后,均在移植后2周骨髓恢复造血。
Objective To study the dynamic changes of bone marrow before and after peripheral hematopoietic stem cell transplantation in patients with intestinal type and very severe bone marrow type radiotherapy. Methods Bone marrow specimens from two patients were subjected to routine Wright staining. Each of the samples was counted under a microscope for 200 nucleated cells. The number of cells and the morphological changes in each stage of the bone marrow were analyzed. Results Case A (enteropathy) had more severe bone marrow injury after irradiation than Case B (very severe myeloid leukemia). In case A, only 15 nucleated cells were found in the bone marrow smear on the 7th day after haploidentical transplantation, but in the granulocytic, erythroid and megakaryocytic cells recovered after 14 days of transplantation, no hematopoietic function was found Megakaryocytic plate. Case B was reconstituted with bone marrow and erythroid after 7 days of allograft transplantation. All three lines of bone marrow recovered at 14 days after transplantation, and the cell ratios in each stage were approximately in the normal range. Conclusion Two patients with acute radiation sickness had severe bone marrow injury after irradiation. However, the hematopoietic recovery of the bone marrow was achieved 2 weeks after transplantation in both hemocompatibilized and fully matched peripheral blood stem cell transplantation.