Garderet L, Bittencourt H, Kaliski A, Daniel M, Ribaud P, Socié G, Gluckman E
Service d'Hématologie-Greffe de Moelle, Hôpital Saint Louis, Paris, France.
Eur J Haematol. 2001 Feb;66(2):137-9. doi: 10.1034/j.1600-0609.2001.00377.x.
T-prolymphocytic leukemia (T-PLL) is a rare disease of the elderly characterized by a high white blood cell count and organomegaly, and is currently incurable. Our aim was to elicit graft-versus-leukemia reactions in a patient with T-PLL.
A 52-yr-old woman with refractory T-PLL underwent a nonmyeloablative regimen followed by allogeneic peripheral blood stem cell transplantation (a "minitransplant") from her HLA-matched sibling.
There was no treatment related toxicity other than neutropenia. Engraftment was successful. The patient experienced no graft-versus-host disease (GVHD) at any time but, on day 84 after transplantation, had a relapse in the central nervous system. Despite infusion of donor lymphocytes and intralumbar chemotherapy, she died on day 157 of systemic disease.
The reasons why treatment may have failed are discussed (nature of disease, disease progression, treatment schedule).
T 细胞幼淋巴细胞白血病（T-PLL）是一种老年人的罕见疾病，其特征为白细胞计数高和器官肿大，目前无法治愈。我们的目的是在一名 T-PLL 患者中引发移植物抗白血病反应。
一名 52 岁难治性 T-PLL 女性患者接受了非清髓性方案，随后接受了来自 HLA 匹配同胞的异基因外周血干细胞移植（“微型移植”）。
除中性粒细胞减少外，无治疗相关毒性。植入成功。患者在任何时候均未发生移植物抗宿主病（GVHD），但在移植后第 84 天，中枢神经系统出现复发。尽管输注了供体淋巴细胞并进行了鞘内化疗，她仍于全身性疾病第 157 天死亡。
讨论了治疗可能失败的原因（疾病性质、疾病进展、治疗方案）。
