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儿童原发性难治性急性髓细胞白血病采用CLAG-M化疗后行脐带血干细胞移植:一例报告

CLAG-M chemotherapy followed by umbilical cord blood stem cell transplantation for primary refractory acute myeloid leukaemia in a child: A case report.

作者信息

Huang Jie, Yang Xiao-Yun, Rong Liu-Cheng, Xue Yao, Zhu Jun, Fang Yong-Jun

机构信息

Department of Haematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, Jiangsu Province, China.

出版信息

World J Clin Cases. 2020 Nov 26;8(22):5603-5610. doi: 10.12998/wjcc.v8.i22.5603.

Abstract

BACKGROUND

The prognosis of paediatric primary refractory/relapsed acute myeloid leukaemia (R/R AML) remains poor. Intensive therapy is typically used as salvage treatment for those with R/R AML. No data are currently available about the use of the CLAG-M protocol as salvage therapy in paediatric patients with R/R AML.

CASE SUMMARY

An 8-year-old patient was diagnosed with acute myeloid leukaemia by bone marrow morphology and immunophenotype. The patient showed poor response to two cycles of induction therapy with 60% blast cells in the bone marrow after the second induction cycle. The patient achieved complete remission after being treated with the CLAG-M protocol as salvage therapy before undergoing umbilical cord blood stem cell transplantation. Morphological complete remission with haematological recovery has hitherto been maintained over 4 mo. Abnormal gene mutations detected at diagnosis were undetectable after haematopoietic stem cell transplantation.

CONCLUSION

Here we present a paediatric patient with primary refractory acute myeloid leukaemia who was successfully treated with the CLAG-M protocol. Given the positive results of the presented patient, large-scale clinical studies are required to assess the role of the CLAG-M protocol in the salvage treatment of refractory or relapsed AML in childhood.

摘要

背景

儿童原发性难治性/复发性急性髓系白血病(R/R AML)的预后仍然很差。强化治疗通常用于R/R AML患者的挽救治疗。目前尚无关于CLAG-M方案在儿童R/R AML患者中作为挽救治疗应用的数据。

病例摘要

一名8岁患者通过骨髓形态学和免疫表型诊断为急性髓系白血病。该患者对两个周期的诱导治疗反应不佳,第二个诱导周期后骨髓中原始细胞比例为60%。该患者在接受CLAG-M方案作为挽救治疗后实现完全缓解,随后接受脐带血干细胞移植。迄今为止,形态学完全缓解伴血液学恢复已维持超过4个月。诊断时检测到的异常基因突变在造血干细胞移植后未检测到。

结论

在此,我们报告了一名原发性难治性急性髓系白血病的儿科患者,其通过CLAG-M方案成功治疗。鉴于该患者的阳性结果,需要进行大规模临床研究以评估CLAG-M方案在儿童难治性或复发性AML挽救治疗中的作用。

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