Miyagaki Satoshi, Imamura Toshihiko, Okumura Yoshiki, Ito Ikuyo, Fujiki Atsushi, Osone Shinya, Ishida Hiroyuki, Hosoi Hajime
Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto.
Department of Pediatrics, Matsushita Memorial Hospital, Moriguchi, Japan.
Pediatr Int. 2015 Aug;57(4):791-4. doi: 10.1111/ped.12643. Epub 2015 Jul 6.
Relapsed anaplastic large cell lymphoma (ALCL) is chemosensitive, but recurrence is common. Although vinblastine (VLB) monotherapy is an effective treatment for relapsed ALCL, the optimal treatment duration is unknown, and some patients experience further relapse after completing the treatment. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is also an effective treatment for relapsed ALCL, although transplant-related toxicity is a problem. Here, we report an 11-year-old patient with relapsed ALCL who underwent induction therapy with VLB monotherapy and achieved complete remission (CR) after 12 courses. CR was confirmed on positron emission tomography-computed tomography. The patient then underwent allo-HSCT with reduced intensity conditioning (fludarabine, melphalan, and low-dose total body irradiation). He developed grade II acute graft-versus-host disease (GVHD), which was successfully treated with methylprednisolone. There was no evidence of chronic GVHD. He has remained in CR without any complications for 19 months after allo-HSCT.
复发的间变性大细胞淋巴瘤（ALCL）对化疗敏感，但复发很常见。虽然长春花碱（VLB）单药治疗是复发ALCL的有效治疗方法，但最佳治疗持续时间尚不清楚，一些患者在完成治疗后会进一步复发。异基因造血干细胞移植（allo-HSCT）也是复发ALCL的有效治疗方法，尽管移植相关毒性是一个问题。在此，我们报告一名11岁复发ALCL患者，其接受了VLB单药诱导治疗，12个疗程后达到完全缓解（CR）。正电子发射断层扫描-计算机断层扫描证实了CR。然后该患者接受了减低强度预处理（氟达拉滨、美法仑和低剂量全身照射）的allo-HSCT。他发生了II级急性移植物抗宿主病（GVHD），经甲泼尼龙成功治疗。没有慢性GVHD的证据。allo-HSCT后19个月，他一直处于CR状态，没有任何并发症。
