黄克智, 李益清, 谢少凡, 等. 二次移植成功治疗急性白血病单倍体造血干细胞移植植入失败[J]. 器官移植, 2023, 14(3): 427-434. DOI: 10.3969/j.issn.1674-7445.2023.03.015
引用本文: 黄克智, 李益清, 谢少凡, 等. 二次移植成功治疗急性白血病单倍体造血干细胞移植植入失败[J]. 器官移植, 2023, 14(3): 427-434. DOI: 10.3969/j.issn.1674-7445.2023.03.015
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Huang Kezhi, Li Yiqing, Xie Shaofan, et al. Successful treatment of acute leukemia by secondary transplantation after the first haploidentical hematopoietic stem cell transplantation failure[J]. ORGAN TRANSPLANTATION, 2023, 14(3): 427-434. DOI: 10.3969/j.issn.1674-7445.2023.03.015
Citation: Huang Kezhi, Li Yiqing, Xie Shaofan, et al. Successful treatment of acute leukemia by secondary transplantation after the first haploidentical hematopoietic stem cell transplantation failure[J]. ORGAN TRANSPLANTATION, 2023, 14(3): 427-434. DOI: 10.3969/j.issn.1674-7445.2023.03.015
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二次移植成功治疗急性白血病单倍体造血干细胞移植植入失败

Successful treatment of acute leukemia by secondary transplantation after the first haploidentical hematopoietic stem cell transplantation failure

    摘要
  • 摘要:
      目的  探讨急性白血病患者首次单倍体造血干细胞移植后植入失败的二次移植治疗策略。
      方法  2例急性白血病患者首次单倍体造血干细胞移植的2例供者均伴有地中海贫血，分别采集CD34+细胞2.57×106/kg和1.99×106/kg，首次单倍体造血干细胞移植植入失败。二次移植更换为非地中海贫血供者，分别采集CD34+细胞4.28×106/kg和5.75×106/kg，采用减低剂量氟达拉滨（Flu）+白消安（Bu）+抗胸腺细胞球蛋白（ATG）预处理方案行二次移植。
      结果  2例患者二次移植中性粒细胞和血小板植入时间分别为+12 d和+10 d、+10 d和+10 d。截止至末次随访时间（分别为二次移植+1 062 d、+265 d），2例患者原发病均完全缓解，无明显移植并发症。
      结论  减低剂量预处理的二次移植能够成功治疗急性白血病单倍体造血干细胞移植植入失败。

     

    Abstract:
      Objective  To evaluate the feasibility of secondary transplantation for patients with acute leukemia after failure of the first haploidentical hematopoietic stem cell transplantation.
      Methods  Two acute leukemia patients underwent the first haploidentical hematopoietic stem cell transplantation from two donors with thalassemia, and the number of collected CD34+ cells was 2.57×106/kg and 1.99×106/kg per donor, respectively. The first haploidentical hematopoietic stem cell transplantation failed. Secondary transplantation was performed from two non-thalassemia donors, and the number of collected CD34+ cells was 4.28×106/kg and 5.75×106/kg per donor, respectively. A reduced-intensity conditioning regimen consisting of fludarabine (Flu), busulfan (Bu) and antithymocyte globulin (ATG) was adopted for the secondary transplantation.
      Results  For two recipients, the time of secondary transplantation of neutrophil and platelet was +12 d and +10 d, +10 d and +10 d, respectively. Up to the final follow-up (+1 062 d and +265 d after secondary transplantation), the primary diseases of both two recipients have been completely relieved without evident post-transplantation complications.
      Conclusions  Secondary transplantation with reduced-intensity conditioning regimen may successfully treat acute leukemia after failure of the first haploidentical hematopoietic stem cell transplantation.

     

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