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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

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
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

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

doi: 10.3969/j.issn.1674-7445.2023.03.015
基金项目: 

国家自然科学基金 82000153

广东省科学技术厅农村科技特派员重点派驻任务 KTP2020324

详细信息
    作者简介:
    通讯作者:

    聂大年(ORCID:0000-0001-6007-6582),博士,主任医师,研究方向为白血病的精准诊疗及造血干细胞移植,Email:niedn@mail.sysu.edu.cn

  • 中图分类号: R617, R551

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

More Information
  • 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。

     

  • 图  1  例1患者治疗全过程

    注:A图为例1患者诊断、化疗、移植、随访全过程;B图为首次单倍体造血干细胞移植过程;C图为二次移植过程。AML为急性髓系白血病;HA为高三尖杉酯碱+阿糖胞苷;D-IA为地西他滨+伊达比星+阿糖胞苷;HD-AraC为大剂量阿糖胞苷;UCB为脐带血;MSC为间充质干细胞;MRD为微小残留病灶。

    Figure  1.  Treatment procedure of patient 1

    图  2  例2患者治疗全过程

    A图为例2患者诊断、化疗、移植、随访全过程;B图为首次单倍体造血干细胞移植过程;C图为二次移植过程。ALL为急性淋巴细胞白血病;VILD为长春地辛+伊达比星+培门冬酶+地塞米松;VCILD为VILD+环磷酰胺;CAM+L为环磷酰胺+阿糖胞苷+巯嘌呤+培门冬酶;HD-MTX为大剂量甲氨蝶呤。

    Figure  2.  Treatment procedure of patient 2

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  • 收稿日期:  2023-01-08
  • 刊出日期:  2023-05-15

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