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[单倍体相合移植后再生障碍性贫血患儿中基于利妥昔单抗治疗的爱泼斯坦-巴尔病毒相关淋巴细胞增殖性疾病:一项前瞻性单中心研究]

[Rituximab based treatment in pediatric Epsstain Bar Virus associated lymphocyte proliferative diseases after aplastic anemia with haplo-identical transplantation:a prospective single centre study].

作者信息

Zhang F, Hu G H, Suo P, Xu Z L, Bai L, Wang H F, Huang S Y M, Xu L P, Chang Y J, Zhang X H, Huang X J, Cheng Y F

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2024 Jul 14;45(7):678-682. doi: 10.3760/cma.j.cn121090-20231229-00345.

DOI:10.3760/cma.j.cn121090-20231229-00345
PMID:39231773
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11388132/
Abstract

Epstein-Barr virus (EBV) associated post-transplant lymphoproliferative disorders (PTLD) are one of the most severe complications after hematopoietic stem cell transplantation (HSCT). This study includes 31 cases of aplastic anemia (AA) patients who developed PTLD after haploidentical transplantation, summarizing their clinical characteristics and categorizing them into either rituximab monotherapy group or combination therapy group based on whether their condition improved by 1 log after a single dose of rituximab. The incidence of PTLD after HSCT in children with AA was 10.16%, and the incidence of PTLD in patients with age >10 years was significantly increased ((2)=11.336, =0.010). Of the 31 patients, 27 were clinically diagnosed and 4 were pathologically confirmed. Finally, 15 patients were classified into the rituximab treatment group and 15 patients into the combination treatment groups. Finally three patients died, and the 2-year overall survival rate was (89.7±5.6) %. Standard pre-treatment protocols and EBV reactivation are risk factors affecting the prognosis of PTLD. There was no statistically significant difference in the impact of the two treatment schemes on prognosis.

摘要

爱泼斯坦-巴尔病毒(EBV)相关的移植后淋巴组织增生性疾病(PTLD)是造血干细胞移植(HSCT)后最严重的并发症之一。本研究纳入了31例单倍体移植后发生PTLD的再生障碍性贫血(AA)患者,总结其临床特征,并根据单剂量利妥昔单抗治疗后病情是否改善1个对数将其分为利妥昔单抗单药治疗组或联合治疗组。AA患儿HSCT后PTLD的发生率为10.16%,年龄>10岁患者的PTLD发生率显著升高(χ²=11.336,P=0.010)。31例患者中,27例为临床诊断,4例为病理确诊。最终,15例患者被分为利妥昔单抗治疗组,15例患者被分为联合治疗组。最终3例患者死亡,2年总生存率为(89.7±5.6)%。标准预处理方案和EBV再激活是影响PTLD预后的危险因素。两种治疗方案对预后的影响无统计学差异。

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本文引用的文献

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[Chinese consensus on the diagnosis and management of Epstein-Barr virus-related post-transplant lymphoproliferative disorders after hematopoietic stem cell transplantation (2022)].[造血干细胞移植后EB病毒相关移植后淋巴增殖性疾病诊断和管理的中国专家共识(2022年)]
Zhonghua Xue Ye Xue Za Zhi. 2022 Sep 14;43(9):716-725. doi: 10.3760/cma.j.issn.0253-2727.2022.09.002.
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Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2022 Aug;30(4):1224-1229. doi: 10.19746/j.cnki.issn.1009-2137.2022.04.040.
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A modified conditioning regimen based on low-dose cyclophosphamide and fludarabine for haploidentical hematopoietic stem cell transplant in severe aplastic anemia patients at risk of severe cardiotoxicity.一种基于低剂量环磷酰胺和氟达拉滨的改良预处理方案,用于有严重心脏毒性风险的重型再生障碍性贫血患者的单倍体造血干细胞移植。
Clin Transplant. 2022 Jan;36(1):e14514. doi: 10.1111/ctr.14514. Epub 2021 Oct 30.
4
Epstein-Barr virus related post-transplant lymphoproliferative disorder prevention strategies in allogeneic hematopoietic stem cell transplantation.异基因造血干细胞移植中与爱泼斯坦-巴尔病毒相关的移植后淋巴细胞增殖性疾病预防策略
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5
Successful preemptive therapy with single-dose rituximab for Epstein-Barr virus infection to prevent post-transplant lymphoproliferative disease after pediatric hematopoietic stem cell transplantation.单剂量利妥昔单抗对爱泼斯坦-巴尔病毒感染进行成功的抢先治疗,以预防儿童造血干细胞移植后移植后淋巴细胞增殖性疾病。
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