Blood:成人慢性原发性中性粒细胞减少症(CPN),女性患者居多

2015-10-08 徐媛 MedSci原创

CPN

成人严重慢性原发性中性粒细胞减少症(CPN)是一种罕见病,在成人CPN患者的长期预后和严重感染还没有明确其风险因素。本研究对108名CPN严重成年患者进行多机构的研究观察。CPN成年患者大多是女性,占比为78%,诊断中位年龄为28.3岁。有62%患者诊断是偶然的。诊断时中位绝对中性粒细胞计数(ANC)是0.4×109/L,以及在随访期间,无粒细胞集落刺激因子(G-CSF)的中位ANC为0.5×10

成人严重慢性原发性中性粒细胞减少症(CPN)是一种罕见病,在成人CPN患者的长期预后和严重感染还没有明确其风险因素。本研究对108名CPN严重成年患者进行多机构的研究观察。

CPN成年患者大多是女性,占比为78%,诊断中位年龄为28.3岁。有62%患者诊断是偶然的。诊断时中位绝对中性粒细胞计数(ANC)是0.4×109/L,以及在随访期间,无粒细胞集落刺激因子(G-CSF)的中位ANC为0.5×109/L。有34.8%名患者存在中性粒细胞自身抗体,12.8%名患者存在T细胞克隆。中性粒细胞自身抗体和T细胞克隆与任何临床性或生物学特征不相关。平均随访8.3年期间,27名患者被44种严重的细菌感染。间断性(n = 24)和持续性(n = 26)接受G-CSF的50名患者发生缓解(96%)。

19个患者接受免疫抑制疗法:总缓解率(OR)为41%,平均响应时间是3个月。发生严重细菌感染的唯一的预测因素为ANC计数低于0.2 × 109/L(OR,0.76)。成人患CPN的特点:女性居多,低严重的细菌感染预后良好,继发性恶性肿瘤不显著。G-CSF耐受性良好,但对多数患者来说不是必需的。

原始出处

Sicre de Fontbrune F1, Moignet A2, Beaupain B3, Suarez F4, Galicier L5, Socié G1, Varet B4, Coppo P6, Michel M7, Pautas C8, Oksenhendler E5, Lengline E9, Terriou L10, Moreau P11, Chantepie S12, Casadevall N6, Michot JM13, Gardembas M14, Michallet M15, Croisille L16, Audrain M17, Bellanné-Chantelot C18, Donadieu J3, Lamy T2; French Severe Chronic Neutropenia Registry.Severe chronic primary neutropenia in adults: report on a series of 108 patients.Blood. 2015 Oct 1;

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