Clinical analysis of 72 cases of immunorelated pancytopenia with positive BMMNC-Coombs tests
- VernacularTitle:骨髓单个核细胞Coombs试验阳性免疫相关性血细胞减少症72例临床分析
- Author:
Hong LIU
;
Zonghong SHAO
;
Rong FU
- Publication Type:Journal Article
- Keywords:
Pancytopenia;
Clinical characteristics;
Immunorelated pancytopenia
- From:
Chinese Journal of Practical Internal Medicine
2006;0(16):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical and laboratory features of the patients with immunorelated pancytopenia(IRP).Methods The risk factors,manifestations,blood cell counts,bone marrow phenotypes,autoantibodies and immunosuppressive therapy response of 72 patients with IRP were analyzed.Then they were followed up for(6 ~36)months,to see their long-term outcome and the prognostic factors.Results The infection,anaphylaxis and pregnancy were highly suspected to be the risk factors of IRP.Most of these patients were with pancytopenia72.2%(52/72);91.7%(66/72)of them were anemic with large or normal MCV;75.0%(54/72)of them were with leukopenia;18.1%(13/72)of them had fever.Thrombocytopenia was common,but serious bleeding rare.68.1% of these cases were with normal or decreased bone marrow cellularities and increased normoblasts.They were all found to have positive results of bone marrow mononuclear cell Coombs test,negative results of routine hemolysis tests and no evidence of malignant clonal hematopoiesis.42.9%(18/42)of these patients had C3 decreased,and 19.0%(8/42)C4 decreased.Immunosuppressive therapy was administered to 72 IRP patients.The response rate at 36 months was 87.5%(28/32).Conclusion IRP is a blood disease induced by acquired autoantibodies mediated bone marrow inhibition or destruction.It manifests pancytopenia with relative higher percentages of reticulocytes and neutrophils,and responds well to immunosuppressive therapy.
