异基因造血干细胞移植后骨髓增生异常综合征快速复发，停用免疫抑制剂后实现持续无病生存：一例报告
Sustained disease-free survival achieved with withdrawal of immunosuppression after rapid relapse of myelodysplastic syndrome following myeloablative allogeneic hematopoietic transplantation: a case report.
作者信息
Hamilton Betty K, Vereb Gregory, Copelan Edward A
机构信息
Bone Marrow Transplant Program, Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
出版信息
J Med Case Rep. 2013 Jan 14;7:18. doi: 10.1186/1752-1947-7-18.
INTRODUCTION
Relapse after allogeneic hematopoietic stem cell transplantation in patients with myelodysplasia is a challenging problem with limited treatment options. Attempts to induce a graft-versus-leukemia effect have been used with limited success. In patients with myelodysplasia, sustained complete remissions have generally been limited to patients with long-term remission after transplant and those with low numbers of marrow blasts.
CASE PRESENTATION
We report the case of a 41-year-old Caucasian woman with relapsed myelodysplastic syndrome and a high blast percentage six months after undergoing an allogeneic transplant who achieved a sustained complete remission after withdrawal of immunosuppression alone.
CONCLUSION
This case highlights the importance of a reasonable period of observation after withdrawing immunosuppression to induce graft-versus-leukemia, and the potential effectiveness of that approach.
引言
骨髓增生异常综合征患者异基因造血干细胞移植后的复发是一个具有挑战性的问题，治疗选择有限。诱导移植物抗白血病效应的尝试取得的成功有限。在骨髓增生异常综合征患者中，持续完全缓解通常仅限于移植后长期缓解的患者以及骨髓原始细胞数量较少的患者。
病例报告
我们报告了一例41岁的白种女性患者，其骨髓增生异常综合征复发，在接受异基因移植6个月后原始细胞比例很高，仅通过停用免疫抑制就实现了持续完全缓解。
结论
该病例突出了在停用免疫抑制后进行合理观察期以诱导移植物抗白血病的重要性，以及该方法的潜在有效性。
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