Tsuji Hitomi, Wada Takashi, Murakami Masamoto, Kashiwagi Takayuki, Ito Yasuhiro, Ishida-Yamamoto Akemi, Jimbo Junko, Shindo Motohiro, Sato Kazuya, Kohgo Yutaka, Iizuka Hajime
Department of Dermatology, Asahikawa Medical College, Hokkaido, Japan.
J Dermatol. 2010 Dec;37(12):1040-5. doi: 10.1111/j.1346-8138.2010.00985.x. Epub 2010 Sep 28.
Mycosis fungoides is a cutaneous T-cell lymphoma, which is clinically divided into three stages: patch, plaque and tumor. Despite a variety of treatments the prognosis is poor in advanced mycosis fungoides. Recently, allogeneic hematopoietic stem cell transplantation has been successfully applied for such cases. We performed reduced-intensity umbilical cord blood transplantation for two advanced mycosis fungoides patients. Case 1 was a 56-year-old man and case 2 was a 30-year-old woman. Tumors of each case were refractory to conventional chemotherapy. Although radiation therapy was considerably effective, tumors relapsed after several months. Reduced-intensity umbilical cord blood transplantation was performed because case 1 had no human leukocyte antigen-identical siblings and the sibling of case 2 did not agree to be the donor. The male patient died of pulmonary failure 23 days after reduced-intensity umbilical cord blood transplantation. The case 2 patient succeeded in reduced-intensity umbilical cord blood transplantation and remained in complete/partial remission for 13 months. However, chemotherapy-resistant tumors relapsed, and allogeneic hematopoietic stem cell transplantation was performed at 17 months. She died of cerebral hemorrhage 23 days after the procedure. Reduced-intensity umbilical cord blood transplantation may be included in the treatments for advanced mycosis fungoides, where graft-versus-lymphoma effect seems to be a significant factor for the success of the treatment.
蕈样肉芽肿是一种皮肤T细胞淋巴瘤，临床上分为三个阶段：斑片期、斑块期和肿瘤期。尽管有多种治疗方法，但晚期蕈样肉芽肿的预后较差。最近，异基因造血干细胞移植已成功应用于此类病例。我们对两名晚期蕈样肉芽肿患者进行了低强度脐带血移植。病例1是一名56岁男性，病例2是一名30岁女性。每个病例的肿瘤对传统化疗均耐药。尽管放射治疗相当有效，但数月后肿瘤复发。由于病例1没有人类白细胞抗原完全匹配的同胞，且病例2的同胞不同意作为供体，因此进行了低强度脐带血移植。男性患者在低强度脐带血移植后23天死于呼吸衰竭。病例2患者低强度脐带血移植成功，并完全/部分缓解持续了13个月。然而，化疗耐药的肿瘤复发，17个月时进行了异基因造血干细胞移植。术后23天她死于脑出血。低强度脐带血移植可能纳入晚期蕈样肉芽肿的治疗方案，其中移植物抗淋巴瘤效应似乎是治疗成功的重要因素。
