国际输血及血液学杂志
國際輸血及血液學雜誌
국제수혈급혈액학잡지
INTERNATIONAL JOURNAL OF BLOOD TRANSFUSION AND HEMATOLOGY
2014年
4期
311-315
,共5页
吴亚妹%曹永彬%李晓红%徐丽昕%刘周阳%刘蓓%闫蓓%杨雪良%李松威
吳亞妹%曹永彬%李曉紅%徐麗昕%劉週暘%劉蓓%閆蓓%楊雪良%李鬆威
오아매%조영빈%리효홍%서려흔%류주양%류배%염배%양설량%리송위
地西他滨%造血干细胞移植%桥接治疗%白血病,单核细胞,急性
地西他濱%造血榦細胞移植%橋接治療%白血病,單覈細胞,急性
지서타빈%조혈간세포이식%교접치료%백혈병,단핵세포,급성
Decitabine%Hematopoietic stem cell transplantation%Bridge therapy%Leukemia,monocytic,acute
目的 探讨地西他滨(DAC)用于难治急性单核细胞白血病患者进行异基因造血干细胞移植(allo-HSCT)之前桥接治疗的可行性及其疗效.方法 选择2011年11月解放军总医院第一附属医院收治的1例难治急性单核细胞白血病患者为研究对象.本例患者连续接受7个方案化疗,并给予DAC桥接治疗及白消安+环磷酰胺(BUCY)改良方案预处理后,行单倍体造血干细胞移植(haplo-HSCT),回顾性分析该例患者临床资料并结合近年相关文献进行分析.本研究遵循的程序符合解放军总医院第一附属医院人体试验委员会制定的伦理学标准,得到该委员会批准,并征得受试对象的知情同意.结果 该例患者经DAC桥接治疗后,预处理过程顺利,干细胞植入成功,仅出现Ⅰ度急性移植物抗宿主病(aGVHD),局限性慢性GVHD(cGVHD),移植后1个月、6个月、12个月及24个月时,患者均呈完全供者嵌合体型,且未检测到微小残留病(MRD)病灶.本例患者获得完全缓解(CR),迄今已病情无复发存活25个月.结论 对于本例多耐药的难治性急性白血病患者,给予DAC桥接haplo-HSCT治疗,安全可行,并可有效减轻移植后复发风险,明显提高患者生存时间.
目的 探討地西他濱(DAC)用于難治急性單覈細胞白血病患者進行異基因造血榦細胞移植(allo-HSCT)之前橋接治療的可行性及其療效.方法 選擇2011年11月解放軍總醫院第一附屬醫院收治的1例難治急性單覈細胞白血病患者為研究對象.本例患者連續接受7箇方案化療,併給予DAC橋接治療及白消安+環燐酰胺(BUCY)改良方案預處理後,行單倍體造血榦細胞移植(haplo-HSCT),迴顧性分析該例患者臨床資料併結閤近年相關文獻進行分析.本研究遵循的程序符閤解放軍總醫院第一附屬醫院人體試驗委員會製定的倫理學標準,得到該委員會批準,併徵得受試對象的知情同意.結果 該例患者經DAC橋接治療後,預處理過程順利,榦細胞植入成功,僅齣現Ⅰ度急性移植物抗宿主病(aGVHD),跼限性慢性GVHD(cGVHD),移植後1箇月、6箇月、12箇月及24箇月時,患者均呈完全供者嵌閤體型,且未檢測到微小殘留病(MRD)病竈.本例患者穫得完全緩解(CR),迄今已病情無複髮存活25箇月.結論 對于本例多耐藥的難治性急性白血病患者,給予DAC橋接haplo-HSCT治療,安全可行,併可有效減輕移植後複髮風險,明顯提高患者生存時間.
목적 탐토지서타빈(DAC)용우난치급성단핵세포백혈병환자진행이기인조혈간세포이식(allo-HSCT)지전교접치료적가행성급기료효.방법 선택2011년11월해방군총의원제일부속의원수치적1례난치급성단핵세포백혈병환자위연구대상.본례환자련속접수7개방안화료,병급여DAC교접치료급백소안+배린선알(BUCY)개량방안예처리후,행단배체조혈간세포이식(haplo-HSCT),회고성분석해례환자림상자료병결합근년상관문헌진행분석.본연구준순적정서부합해방군총의원제일부속의원인체시험위원회제정적윤리학표준,득도해위원회비준,병정득수시대상적지정동의.결과 해례환자경DAC교접치료후,예처리과정순리,간세포식입성공,부출현Ⅰ도급성이식물항숙주병(aGVHD),국한성만성GVHD(cGVHD),이식후1개월、6개월、12개월급24개월시,환자균정완전공자감합체형,차미검측도미소잔류병(MRD)병조.본례환자획득완전완해(CR),흘금이병정무복발존활25개월.결론 대우본례다내약적난치성급성백혈병환자,급여DAC교접haplo-HSCT치료,안전가행,병가유효감경이식후복발풍험,명현제고환자생존시간.
Objective To investigate the feasibility and efficacy of decitabine (DAC) bridge therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with refractory acute monocytic leukemia (AML).Methods In November 2011,a case of refractory acute AML who admitted by the First Affiliated Hospital of Chinese PLA General Hospital was included in this study.This patient recived 7 kinds of chemotherapy regimens,and then underwent with DAC bridge therapy and busulfan combined cyclophosphamide (BUCY) regimen before haploidentical HSCT (haplo-HSCT).The clinical data of this patient were analyzed retrospectively,and its related literatures were reviewed.The clinical protocol and consent forms were approved by the institutional review board for human investigation at the First Affiliated Hospital of Chinese PLA General Hospital.Patient provided written informed consent for inclusion in the study.Results With DAC bridge therapy,this patient achieved successful engraftment and experienced only grade Ⅰ actue graft-versus-host disease (aGVHD) and limited chronic GVHD (cGVHD).This patient achieved full donor chimerism (FDC) and didn't monitor minimal residual disease (MRD) in 1,6,12 and 24 months after HSCT.Until now,he was in 25 months progression-free survival (PFS) and no relapse.Conclusions DAC bridge therapy followed by haplo-HSCT is safe and feasibility for the patient with multidrug resistance (MDR) and refractory AML,which could reduce the relapse efficiently and prolong life-span of the patients.
