[异基因骨髓移植后慢性髓性白血病急变期复发采用无关供者淋巴细胞输注获得完全细胞遗传学缓解]

[Complete cytogenetic response obtained with unrelated donor lymphocyte infusion for relapse of chronic myeloid leukemia in blastic crisis after allogeneic bone marrow transplantation].

作者信息

Fujimaki K, Maruta A, Yoshida M, Yamazaki E, Matsuzaki M, Fujisawa S, Kanamori H, Ishigatsubo Y

机构信息

Department of Hematology, Kanagawa Cancer Center.

出版信息

Rinsho Ketsueki. 2001 Mar;42(3):204-8.

PMID:11345783

Abstract

A 35-year-old man with chronic myeloid leukemia (CML) in blastic crisis (BC) received an allogeneic bone marrow transplant from an unrelated donor in October 1998 after three cycles of chemotherapy. BC relapse developed on day 349 after transplantation. After one cycle of chemotherapy and treatment with interferon, the patient received donor lymphocyte infusion (DLI), and this resulted in a complete cytogenetic response 21 days later. Grade III acute graft-versus-host disease developed on day 25 after DLI, but this was resolved after administration of prednisolone. Disease relapse occurred at extramedullary sites on day 162 after DLI, and the patient died of sepsis after receiving chemotherapy. This case illustrates that unrelated DLI can induce remission successfully in patients with relapse of CML in BC through a graft-versus-leukemia effect.

摘要

一名35岁处于急变期（BC）的慢性髓性白血病（CML）男性患者，在接受三个周期化疗后，于1998年10月接受了来自无关供者的异基因骨髓移植。移植后第349天发生BC复发。在一个周期化疗及干扰素治疗后，患者接受了供者淋巴细胞输注（DLI），21天后获得完全细胞遗传学缓解。DLI后第25天发生Ⅲ级急性移植物抗宿主病，但在给予泼尼松龙后病情缓解。DLI后第162天髓外部位出现疾病复发，患者在接受化疗后死于败血症。该病例表明，无关供者DLI可通过移植物抗白血病效应成功诱导处于BC期的CML复发患者缓解。