中文摘要：

目的了解异基因造血干细胞移植（allo—HSCT）后与慢性移植物抗宿主病（cGVHD）相关的多发性浆膜腔积液患者的临床表现及治疗转归。方法对1999年1月至2008年11月进行allo—HSCT治疗的1385例患者资料进行回顾性分析。并选＋100d后反复出现或持续存在中或大量的多浆膜腔积液且排除感染、肿瘤复发、药物等因素导致的患者进行详细研究。结果1385例患者中有911例患者诊断为cGVHD，其中局限型327例（35．8％），广泛型198例（21．7％）。28例患者出现浆膜腔积液，感染导致的9例，低蛋白血症或肝硬化所致单纯腹腔积液6例；特发性或药物损害导致的单纯少量心包积液7例，复发所致2例。最终有4例患者符合入选条件。这4例患者均为中年男性，接受了同胞相合移植。积液多为漏出液或介于渗漏之间，往往迁延反复，全部患者均有不同程度的cGVHD。小剂量激素治疗有一定疗效，目前均长期生存。结论移植中晚期后的反复发作或持续存在的多浆膜腔积液可以是cGVHD的一种少见表现形式。

英文摘要：

Objective To analyze the presentations and treatments of unexplained multiple effusions after allogeneic hematopoietic transplantation （allo-HSCT） and their relationships with chronic graft-versus- host disease（eGVHD）. Methods The data of 1385 allo-HSCT patients from Jan. 1999 to Nov. 2008 in our institute were reviewed retrospectively. Results cGVHD occurred in 911 patients, including 327 （35.8%） limited cGVHD, and 198 （21.7%） extensive cGVHD. Effusions were identified in 28 patients. Nine cases were from infections and two tumor relapses. Cirrhosis and hypoproteinemia caused aseites in 6 patients. The small amount pericardial effusions occurred in 7 patients, which were related to the toxicity of drugs. The re- maining 4 patients had large and recurrent sterile effusions involving peritoneal, pericardial, pleural cavities and/or testicular sheath cavity. These 4 cases were all middle aged men and received transplantation from HLA identical siblings. The effusions had an insidious onset and were or were proved to be transudate. Exam- inations of the effusions for bacteria, virus and yeast were negative. The only diagnoses of the patients were cGVHD. All of the patiants responded to low dose steroid and alive, but only one achieved complete remission. Conclusion The unexplained recurrent multiple effusions after allo-HSCT might be a rare manifestation of chronic GVHD.