Takahashi Shuichiro, Tsumanuma Riko, Aizawa Keiko, Osakabe Mitsumasa, Maeda Kunihiko, Omoto Ejiro
Department of Hematology, Hokkaido University Graduate School of Medicine, Japan.
Intern Med. 2016;55(22):3351-3356. doi: 10.2169/internalmedicine.55.6435. Epub 2016 Nov 15.
The prognosis for myelodysplastic syndrome with bone marrow fibrosis (MDS-F) is worse than the prognosis of MDS without fibrosis. Hematopoietic stem cell transplantation (HSCT) is the only curative therapy; however, the indications and the procedures involved in HSCT remain unclear. We herein describe a 69-year-old Japanese man with MDS-F who received haploidentical HSCT and post-transplantation cyclophosphamide. Although the first HSCT resulted in secondary graft failure, the second HSCT using PTCy led to successful engraftment after early improvement in fibrosis. Since the incidence of graft failure is high in myelofibrosis patients, a secondary HSCT using PTCy may be successful if employed.
骨髓纤维化的骨髓增生异常综合征（MDS-F）的预后比无纤维化的MDS预后更差。造血干细胞移植（HSCT）是唯一的治愈性疗法；然而，HSCT的适应症和相关程序仍不明确。我们在此描述一名69岁的日本男性MDS-F患者，其接受了单倍体HSCT及移植后环磷酰胺治疗。尽管首次HSCT导致继发性移植物失败，但第二次使用PTCy的HSCT在纤维化早期改善后实现了成功植入。由于骨髓纤维化患者移植物失败的发生率较高，若采用，使用PTCy的二次HSCT可能会成功。
