造血干细胞移植术后并发过客淋巴细胞综合征1例报道及文献复习*

doi:10.3969/j.issn.1671-2587.2026.01.018

临床输血与检验 ›› 2026, Vol. 28 ›› Issue (1): 121-126.DOI: 10.3969/j.issn.1671-2587.2026.01.018

造血干细胞移植术后并发过客淋巴细胞综合征1例报道及文献复习^*

潘亚东¹, 丁梦圆², 杨秀秀¹, 孙亚韵¹, 凌婧¹

¹苏州大学附属儿童医院输血科，江苏苏州 215021;
²苏州市中心血站配型室，江苏苏州 215006

收稿日期:2025-05-30 发布日期:2026-02-13
通讯作者: 凌婧，主要从事儿童出凝血疾病的基础与临床研究，（E-mail）lingjing@suda.edu.cn。
作者简介:潘亚东，主要从事临床输血和输血免疫研究，（E-mail）18114521377@163.com。并列第一作者：丁梦圆，主要从事免疫血液学研究，（E-mail）18168573629@163.com。
基金资助:
*本课题受苏州市儿童出凝血重点实验室（No.SZS2023014）、儿童出凝血疾病的新型治疗技术及临床转化研究（No.SKY2022012）、苏州市姑苏卫生人才计划（No.（2022）143，GSWS2022097）、江苏省输血协会爱康生物科研基金（No.JSAK2023009）资助

Clinical Analysis of a Patient with Passenger Lymphocyte Syndrome Following Hematopoietic Stem Cell Transplantation: Insights from a Case and Literature Review

PAN Yadong¹, DING Mengyuan², YANG Xiuxiu¹, SUN Yayun¹, LING Jing¹

¹Department of Transfusion Medicine, Children's Hospital of Soochow University, Suzhou, 215021;
²Blood Group Reference Laboratory, Suzhou Blood Center, Suzhou, 215006

Received:2025-05-30 Published:2026-02-13

摘要/Abstract

摘要： 目的对ABO血型次要不合（B供A₁B）异基因造血干细胞移植（allogeneic hematopoietic stem cell transplantation, allo-HSCT）术后并发过客淋巴细胞综合征（passenger lymphocyte syndrome, PLS）A₁抗原丢失病例的临床特征、血清学特征、基因型特征和多学科分层管理策略进行探讨，同时结合文献回顾为临床早期识别与治疗提供依据。方法采用微柱凝胶法和试管法检测患儿ABO血型并采用Sanger测序验证血型基因型，根据患儿造血干细胞移植术前后胆红素、乳酸脱氢酶、血红蛋白和网织红细胞百分比变化来评估溶血情况。结果移植后患儿血红蛋白持续下降，网织红细胞百分比、胆红素、乳酸脱氢酶水平升高，提示溶血。ABO血型正反定型不一致;基因测序显示ABO*A1.02/ABO*B.01，但血清学检测A₁抗原丢失。结论本研究为1例allo-HSCT后并发PLS伴A₁抗原短暂丢失的病例报道，提示PLS的诊断需结合ABO血型正反定型矛盾及溶血实验室证据以及PLS的临床异质性，进一步强调了ABO血型监测在多学科协作中的价值。

关键词: 异基因造血干细胞移植, ABO血型不合, 过客淋巴细胞综合征, 抗原丢失

Abstract: Objective Investigation of clinical, serological, and genotypic characteristics and multidisciplinary tiered management strategies in a case of A₁ antigen loss resulting from passenger lymphocyte syndrome (PLS) following ABO minor-incompatible (B to A₁B) allogeneic hematopoietic stem cell transplantation (allo-HSCT), combined with literature review to provide a reference for early clinical identification and treatment. Methods The patient's ABO blood group was determined using both microcolumn gel and tube methods, with genotyping confirmed by Sanger sequencing. Hemolysis was assessed by monitoring pre- and post-transplant changes in total bilirubin, lactate dehydrogenase (LDH), hemoglobin levels, and reticulocyte percentage. Results Following transplantation, the patient exhibited progressive hemoglobin decline, elevated reticulocyte percentage, hyperbilirubinemia, and increased LDH levels—findings indicating hemolysis. Discrepancies were noted between ABO forward and reverse typing. Genetic sequencing confirmed an ABO*A1.02/ABO*B.01 genotype; however, serological testing revealed a transient loss of A₁ antigen expression. Conclusion This case report of transient A₁ antigen loss with passenger lymphocyte syndrome (PLS) following allo-HSCT demonstrates that PLS diagnosis requires the combination of ABO forward/reverse grouping discrepancy, hemolytic laboratory evidence, and recognition of PLS clinical heterogeneity, further highlighting the value of ABO blood group monitoring in multidisciplinary collaboration.

Key words: Allogeneic hematopoietic stem cell transplantation, ABO incompatibility, Passenger lymphocyte syndrome, Antigen loss

中图分类号:

R457

潘亚东, 丁梦圆, 杨秀秀, 孙亚韵, 凌婧. 造血干细胞移植术后并发过客淋巴细胞综合征1例报道及文献复习^*[J]. 临床输血与检验, 2026, 28(1): 121-126.

PAN Yadong, DING Mengyuan, YANG Xiuxiu, SUN Yayun, LING Jing. Clinical Analysis of a Patient with Passenger Lymphocyte Syndrome Following Hematopoietic Stem Cell Transplantation: Insights from a Case and Literature Review[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2026, 28(1): 121-126.

参考文献

[1] MOOSAVI M M,DUNCAN A,STOWELL S R,et al.Passenger lymphocyte syndrome; a review of the diagnosis, treatment,and proposed detection protocol[J]. Transfus Med Rev,2020,34(3):178-187.
[2] 王晓宁,孙长杰,王宇飞,等. O型患者非同型肝移植引发免疫性过客淋巴细胞综合征1例[J]. 临床输血与检验,2021, 23(3):391-394.
[3] 邵迎春,周士源,朱倩,等. ABO血型次要不合的异基因造血干细胞移植合并过客淋巴细胞综合征患者的诊治[J]. 中国输血杂志,2023,36(11):995-999.
[4] 何丽,乾虎,朱晓健,等. 异基因造血干细胞移植后过客淋巴细胞综合征1例报告并文献复习[J]. 内科急危重症杂志, 2023,29(2):168-170.
[5] TESHIGAWARA-TANABE H,HAGIHARA M, MATSUMURA A,et al.Passenger lymphocyte syndrome after ABO-incompatible allogeneic hematopoietic stem cell transplantation;dynamics of ABO allo-antibody and blood type conversion[J]. Hematology, 2021,26(1):835-839.
[6] IWANAGA S,SAKAGUCHI T,NAKANISHI K,et al.Passenger lymphocyte syndrome with hemophagocytic syndrome after peripheral blood stem-cell transplantation from an HLA-matched full biological sibling: case report[J]. Transfus Apher Sci,2012,47(3): 355-358.
[7] NADARAJAH L,ASHMAN N,THURAISINGHAM R,et al.Literature review of passenger lymphocyte syndrome following renal transplantation and two case reports[J]. Am J Transplant,2013,13(6):1594-1600.
[8] KOHL M M,SCHWARZ S,JAKSCH P,et al.High rate of passenger lymphocyte syndrome after ABO minor incompatible lung transplantation[J]. Am J Respir Crit Care Med,2024,209(8):995-1000.
[9] YAZER M H,TRIULZI D J.Immune hemolysis following ABO-mismatched stem cell or solid organ transplantation[J]. Curr Opin Hematol,2007,14(6):664-670.
[10] LEE H J,GULBIS A,DE PADUA SILVA L,et al. Rituximab for passenger lymphocyte syndrome associated with allogeneic SCT[J]. Bone Marrow Transplant, 2008,42(1): 67-69.
[11] TSUJIMURA K,ISHIDA H,TANABE K.Is efficacy of the anti-Cd20 antibody rituximab preventing hemolysis due to passenger lymphocyte syndrome?[J]. Ther Apher Dial,2017,21(1):22-25.
[12] PANARO F,DECHRISTOPHER P J,RONDELLI D,et al.Severe hemolytic Anemia due to passenger lymphocytes after living-related bowel transplant[J]. Clin Transplant, 2004,18(3):332-335.
[13] AUDET M,PANARO F,PIARDI T,et al.Passenger lymphocyte syndrome and liver transplantation[J]. Clin Dev Immunol,2008,2008:715769.
[14] JUNG J,LEE J M,YANG M N,et al.Transient loss of A1 phenotype in a patient with passenger lymphocyte syndrome after ABO minor incompatible liver transplantation: The first case report[J]. Transfus Apher Sci,2018, 57(6): 759-761.
[15] 张嵘,王文婷,顾顺利,等. 过客淋巴细胞综合征监测流程及输血策略探讨[J]. 临床输血与检验,2021,23(6):681-685.
[16] OBEIDALLA A,STAVES J,UDUPA V,et al.Passenger lymphocyte syndrome following small bowel transplantation[J]. Br J Haematol,2022,197(6):650.
[17] ZIMRING J C,CADWELL C M,SPITALNIK S L.Antigen loss from antibody-coated red blood cells[J]. Transfus Med Rev,2009,23(3):189-204.
[18] 王林,张勇萍,崔颖,等. 36例淋巴细胞白血病患者ABO血型抗原减弱的凝集强度分析[J]. 细胞与分子免疫学杂志, 2017,33(5):680-683.
[19] 邵明,吕先萍,汤平,等. 急性白血病ABO抗原减弱患者与抗原正常患者的对比研究[J]. 中国实验血液学杂志, 2017,25(5):1307-1313.
[20] 赵亚玲,张媛媛,邵伟,等. AB血型个体ABO抗原减弱的原因与探讨[J]. 临床输血与检验,2025,27(1):76-82.
[21] WOOLFSON J P,VANDRIEL S M,STEPHENS D,et al.Passenger lymphocyte syndrome after pediatric liver transplantation[J]. J Pediatr Gastroenterol Nutr,2019, 69(1):95-101.
[22] ROMERO S,SOLVES P,LANCHARRO A,et al.Passenger lymphocyte syndrome in liver transplant recipients: a description of 12 cases[J]. Blood Transfus, 2015,13(3): 423-428.
[23] DAVIS S L,VAIDYA A,TIMBS A,et al.Severe haemolysis due to passenger lymphocyte syndrome after an ABO mismatched bowel transplant—a case report[J]. Transfus Med,2011,21(1):65-69.
[24] MIGDADY Y,PANG Y F,KALSI S S,et al.Post-hematopoietic stem cell transplantation immune-mediated Anemia: a literature review and novel therapeutics[J]. Blood Adv,2022,6(8):2707-2721.

造血干细胞移植术后并发过客淋巴细胞综合征1例报道及文献复习^*

Clinical Analysis of a Patient with Passenger Lymphocyte Syndrome Following Hematopoietic Stem Cell Transplantation: Insights from a Case and Literature Review

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