Sugimori N, Nakao S, Takamatsu H, Takami A, Ueda M, Shiobara S, Matsuda T
Third Department of Medicine, Kanazawa University School of Medicine.
Rinsho Ketsueki. 1996 Feb;37(2):134-8.
A 38-year-old female with acute myelogenous leukemia (M2) received an allogeneic bone marrow graft from an HLA-DR one locus-mismatched sister during the first remission. The conditioning regimen consisted of busulfan and cyclophosphamide. Acute graft-versus-host disease (GVHD) developed on day 11 after transplantation. Although the GVHD was successfully treated with methylprednisolone, peripheral blood neutrophils that had begun to increase disappeared in association with improvement of the GVHD and graft rejection was eventually diagnosed. The second bone marrow transplantation from the same donor ended up with engraftment failure. She died of sepsis due to Candida albicans following the development of Epstein-Barr virus-associated B-lymphoproliferative disorder. The clinical course of this patient indicates that successful therapy of severe GVHD with methylprednisolone may lead to marrow graft rejection.
一名38岁患有急性髓性白血病（M2）的女性在首次缓解期接受了来自一位HLA - DR一个位点不匹配的姐妹的异基因骨髓移植。预处理方案包括白消安和环磷酰胺。移植后第11天发生了急性移植物抗宿主病（GVHD）。尽管通过甲基强的松龙成功治疗了GVHD，但开始增加的外周血中性粒细胞随着GVHD的改善而消失，最终被诊断为移植排斥。来自同一供体的第二次骨髓移植以植入失败告终。在发生爱泼斯坦 - 巴尔病毒相关的B淋巴细胞增殖性疾病后，她死于白色念珠菌引起的败血症。该患者的临床病程表明，用甲基强的松龙成功治疗严重GVHD可能导致骨髓移植排斥。
