[Erythrocytosis after hematopoietic stem cell transplantation: report of 3 cases and literature review]

Zhonghua Nei Ke Za Zhi. 2023 Aug 1;62(8):1012-1016. doi: 10.3760/cma.j.cn112138-20221226-00958.
[Article in Chinese]

Abstract

This is a report of three cases of three male patients. One of the patients had myelodysplastic syndrome, and two had aplastic anemia; their ages were 28, 32, and 21 years old, respectively. Two patients underwent sibling allogeneic hematopoietic stem cell transplantation, and one underwent haploidentical hematopoietic stem cell transplantation. All the patients showed elevated hemoglobin and hematocrit at 6, 16, and 9 months after transplantation, with normal white blood cells and platelets and no splenomegaly. All causes of secondary polycythemia were ruled out. Bone marrow morphology showed no erythroid hyperplasia. The PCR result for BCR-ABL (P210, P230, P190, and variants) was negative, and there were no mutations at the amino acid site 617 of JAK2, exon 12 of JAK2, exon 9 of CALR, and amino acid site 515 of MPL. All three patients had hypertension. One patient was treated with amlodipine, and the other two patients were treated with angiotensin receptor blockers. The durations of erythrocytosis for these three patients were 6 years and 3 months, 4 years and 7 months, and 5 years and 3 months, respectively through December 2022. There was no tendency for spontaneous remission. Erythrocytosis after hematopoietic stem cell transplantation is a rare complication. Previous reports in the literature suggest that the mechanism of post-transplant erythrocytosis in recipients of allogeneic hematopoietic stem cell transplantation may be different from that of recipients of other transplants.

报道3例患者均为男性,其中1例患有骨髓增生异常综合征,2例患有再生障碍性贫血;年龄分别为28、32、21岁;2例行同胞全合造血干细胞移植,1例行单倍体造血干细胞移植。3例患者分别在移植后6、16、9个月开始出现血红蛋白、红细胞压积升高,白细胞、血小板基本正常,无脾大,均排除了继发性红细胞增多的原因,期间复查骨髓形态均未见红系增生,基因检测BCR-ABL(P210、P230、P190及变异型)阴性,JAK2第617氨基酸位点、JAK2第12外显子、CALR第9外显子、MPL第515氨基酸位点未突变。3例患者均患有高血压病,1例口服氨氯地平,2例口服血管紧张素受体阻滞剂降压治疗。截至2022年12月,3例患者红细胞增多持续时间分别为6年3个月、4年7个月、5年3个月,均无自发缓解趋势。造血干细胞移植后红细胞增多是一种罕见的并发症,既往文献结果表明异基因造血干细胞移植受体的移植后红细胞增多症机制可能不同于其他移植受体。.

Publication types

  • Review
  • Case Reports
  • English Abstract

MeSH terms

  • Anemia, Aplastic*
  • Bone Marrow
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Male
  • Myelodysplastic Syndromes*
  • Polycythemia* / etiology