[Clinical Analysis of Post-Transplant Lymphoproliferative Disorder after Hematopoietic Stem Cell Transplantation in Severe Aplastic Anemia Patients]

To analyze the clinical characteristics of SAA patients with post-transplantation lymphoproliferative disease (PTLD) after allogeneic hematopoietic stem cell transplantation, and to improve diagnosis and treatment of PTLD.The clinical data of 192 patients with SAA patients who underwent HSCT in a single center from September 2010 to September 2017 were analyzed retrospectively. All patients were received antithymocyte globulin（ATG） conditioning regimen and mesenchymal stem cell(MSC) infusion.Among 192 cases, PTLD occurred in 14 cases, the incidence was 7.29％， 9 of them were diagnosed by pathology， and 5 were diagnosed clinically. EBV infection occurred with a median time of 72（35-168） days, Viral load higher than 1×10The incidence of PTLD after HSCT with SAA who used ATG and MSC in conditioning regimen closely relates to EBV infection, age of patients≤12 years, HLA-mismatch in URD-HSCT, grade II to IV GVHD. Rituximab combined with RIS may reduce the incidence of PTLD, combined EBV-CTL and chemotherapy may be the useful and most important treatment for PTLD.重型再生障碍性贫血患者造血干细胞移植治疗后淋巴组织增殖性疾病的临床分析.分析重型再生障碍性贫血(SAA)患者造血干细胞移植（HSCT）后淋巴组织增殖性疾病(PTLD)的临床特征,以提高对PTLD的诊疗水平.回顾分析2010年9月至2017年9月在单中心行HSCT的192例SAA患者的临床资料，分析PTLD的有效预警和治疗方法。本组患者预处理方案中均含有ATG并接受间充质干细胞（MSC）输注.192例SAA患者HSCT移植后有14例并发了EBV+ PTLD，总体发生率为7.29%，其中临床诊断5例，病理诊断9例，移植后PTLD发生中位时间72(35-168)d,所有PTLD均发生了EBV感染，且EBV高载量大于1×10SAA患者接受预处理含有ATG和MSC的HSCT后PTLD发生与EBV高拷贝密切相关，年龄≤12岁儿童、非血缘HSCT中供者为HLA不全相合的移植及合并有II度以上aGVHD者移植后PTLD高发； RIS/RTX抢先治疗有效，疗效不佳患者及时应用CTL及联合化疗是控制病情有效及重要方法.