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异基因脐带血造血干细胞移植预处理方案对急性髓系白血病患者的造血重建影响

Autologous Hematopoietic Recovery after Unrelated Umbilical Cord Blood Transplantation with Myeloablative Conditioning for Acute Myelogenous Leukemia.

机构信息

Division of Hematology, Saitama Medical Center, Jichi Medical University, Japan.

出版信息

Intern Med. 2020 Oct 1;59(19):2409-2414. doi: 10.2169/internalmedicine.4829-20. Epub 2020 Jun 15.

DOI:10.2169/internalmedicine.4829-20
PMID:32536652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7644496/
Abstract

Autologous hematopoietic recovery after allogeneic hematopoietic cell transplantation (allo-HCT) is rare in patients who receive myeloablative conditioning (MAC). Autologous hematopoietic recovery suggests graft rejection, leading to concerns about subsequent disease relapse. We herein report a rare case of a patient with acute leukemia who experienced autologous hematopoietic recovery after cord blood transplantation (CBT) with total body irradiation-based MAC. Chromosomal abnormalities were repeatedly detected without any disease relapse for eight months. The accumulation of similar cases is required to accurately assess the incidence and clinical outcomes of autologous hematopoietic recovery after CBT with MAC.

摘要

异基因造血细胞移植（allo-HCT）后自体造血恢复在接受清髓性预处理（MAC）的患者中很少见。自体造血恢复提示移植物排斥，这引发了对随后疾病复发的担忧。本文报告了一例急性白血病患者在接受基于全身照射的 MAC 的脐带血移植（CBT）后发生自体造血恢复的罕见病例。在 8 个月的时间里，反复检测到染色体异常，但没有疾病复发。需要积累更多类似病例，以准确评估 MAC 后 CBT 后自体造血恢复的发生率和临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cbc/7644496/2c49595209a7/1349-7235-59-2409-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cbc/7644496/2c49595209a7/1349-7235-59-2409-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cbc/7644496/2c49595209a7/1349-7235-59-2409-g001.jpg

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本文引用的文献

1
Clinical course of autologous recovery with chromosomal abnormalities after allogeneic hematopoietic stem cell transplantation.异基因造血干细胞移植后伴有染色体异常的自体恢复的临床病程。
Bone Marrow Transplant. 2020 Jun;55(6):1023-1028. doi: 10.1038/s41409-019-0765-0. Epub 2019 Dec 9.
2
Single cord blood transplantation in Japan; expanding the possibilities of CBT.日本的单份脐带血移植；扩大了 CBT 的可能性。
Int J Hematol. 2019 Jul;110(1):39-49. doi: 10.1007/s12185-019-02672-4. Epub 2019 May 31.
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ACUTE MYELOID LEUKEMIA, PROSTATE AND SKIN CANCER IN ACUTE RADIATION SYNDROME SURVIVOR AFTER THE 1986 CHERNOBYL NUCLEAR ACCIDENT: CASE REPORT.
1986年切尔诺贝利核事故急性放射综合征幸存者中的急性髓系白血病、前列腺癌和皮肤癌：病例报告
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4
Which is more important for the selection of cord blood units for haematopoietic cell transplantation: the number of CD34-positive cells or total nucleated cells?对于造血细胞移植的脐血单位选择而言，哪个更重要：CD34阳性细胞数量还是总核细胞数量？
Br J Haematol. 2019 Apr;185(1):166-169. doi: 10.1111/bjh.15418. Epub 2018 May 29.
5
Graft failure after allogeneic hematopoietic stem cell transplantation.异基因造血干细胞移植后的移植物失败
Transfus Apher Sci. 2018 Apr;57(2):163-167. doi: 10.1016/j.transci.2018.04.014. Epub 2018 Apr 18.
6
Sources of Hematopoietic Stem and Progenitor Cells and Methods to Optimize Yields for Clinical Cell Therapy.造血干细胞和祖细胞的来源及优化临床细胞治疗产量的方法。
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7
Impact of total body irradiation on successful neutrophil engraftment in unrelated bone marrow or cord blood transplantation.全身照射对非亲缘骨髓或脐血移植中成功中性粒细胞植入的影响。
Am J Hematol. 2017 Feb;92(2):171-178. doi: 10.1002/ajh.24613.
8
A Novel Reduced-Toxicity Myeloablative Conditioning Regimen Using Full-Dose Busulfan, Fludarabine, and Melphalan for Single Cord Blood Transplantation Provides Durable Engraftment and Remission in Nonremission Myeloid Malignancies.一种使用全剂量白消安、氟达拉滨和美法仑的新型低毒性清髓性预处理方案用于单份脐血移植，可在未缓解的髓系恶性肿瘤中实现持久植入和缓解。
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Double unit grafts successfully extend the application of umbilical cord blood transplantation in adults with acute leukemia.双份单位移植物成功地扩展了脐带血移植在急性白血病成人患者中的应用。
Blood. 2013 Jan 31;121(5):752-8. doi: 10.1182/blood-2012-08-449108. Epub 2012 Dec 9.