使用阿扎胞苷成功治疗异基因干细胞移植后复发的急性髓系白血病。
Successful treatment of relapsed AML after allogeneic stem cell transplantation with azacitidine.
作者信息
Graef Thorsten, Kuendgen Andrea, Fenk Roland, Zohren Fabian, Haas Rainer, Kobbe Guido
机构信息
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany.
出版信息
Leuk Res. 2007 Feb;31(2):257-9. doi: 10.1016/j.leukres.2006.03.003. Epub 2006 Apr 18.
Therapeutic options for patients with relapse of MDS or high risk AML after allogeneic stem cell transplantation are limited. We here present the case of a 64-year-old female patient with MDS, who received peripheral blood stem cells from her HLA-identical brother after a non-myeloablative conditioning regimen. Two months after allogeneic transplantation she suffered from a relapse, now fulfilling WHO criteria for AML with a bone marrow blast count of 91%. We then decided to treat her with azacitidine, a DNA methyltransferase inhibitor with proven antileukemic activity. The patient achieved a complete haematological response after two cycles and full donor chimerism after a single dose of donor lymphocytes. We postulate that azacitidine acts through a direct reduction of malignant cells and may in addition augment the immunologic effects of donor lymphocyte infusions.
异基因干细胞移植后复发的骨髓增生异常综合征（MDS）或高危急性髓系白血病（AML）患者的治疗选择有限。我们在此报告一例64岁的MDS女性患者，她在接受非清髓性预处理方案后，从其 HLA 相同的哥哥那里接受了外周血干细胞。异基因移植两个月后，她病情复发，此时骨髓原始细胞计数为91%，符合世界卫生组织（WHO）的AML标准。然后我们决定用阿扎胞苷治疗她，阿扎胞苷是一种已证实具有抗白血病活性的DNA甲基转移酶抑制剂。患者在两个疗程后达到完全血液学缓解，在单次输注供体淋巴细胞后实现完全供体嵌合。我们推测阿扎胞苷通过直接减少恶性细胞发挥作用，此外还可能增强供体淋巴细胞输注的免疫效应。
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