地西他滨联合造血干细胞移植治疗骨髓增生异常综合征转化急性白血病

Decitabine application combined with allogeneic hematopoietic stem cell transplantation for treatment of acute leukemia progressed from myelodysplastic syndrome

背景:由骨髓增生异常综合征转化的急性白血病为难治白血病,临床疗效差,缓解率低,生存期短,因此探索新的有效治疗方法极为重要。目的:观察地西他滨联合造血干细胞移植治疗骨髓增生异常综合征转化急性白血病的临床疗效及并发症。方法:骨髓增生异常综合征转化的急性髓细胞白血病患者1例,先后予2个疗程地西他滨及异基因造血干细胞移植,观察临床疗效、地西他滨的毒副作用及移植相关并发症。结果与结论:经2个疗程地西他滨治疗后,达到完全缓解,主要不良反应为骨髓抑制并发感染,该患者再接受异基因造血干细胞移植后获得无病生存213d,移植过程中出现急性移植物抗宿主病及肺部感染。结果提示地西他滨联合造血干细胞移植治疗骨髓增生异常综合征转化急性白血病获得良好效果,毒副作用及相关并发症可控制,为临床上骨髓增生异常综合征转化急性白血病的治疗提供了新方法。

BACKGROUND： Acute leukemia progressed from myelodysplastic syndrome is a refractory disease with poor clinical therapeutic effect, low remission rate and short survival period. Therefore, it is extremely important to explore a new and effective treatment method. OBJECTIVE： To investigate the clinical therapeutic effects and complications of decitabine application combined with allogeneic hematopoietic stem cell transplantation in treatment of acute leukemia progressed from myelodysplastic syndrome. METHODS： One patient with acute leukemia progressed from myelodysplastic syndrome received two courses of decitabine application combined with allogeneic hematopoietic stem cell transplantation. Clinical curative effects, the side effects of decitabine and the complications of allogeneic hematopoietic stem cell transplantation were investigated. RESULTS AND CONCLUSION： The patient achieved complete remission after two courses of decitabine application combined with allogeneic hematopoietic stem cell transplantation with infection and myelosuppresison. The patient lived without disease for 213 days although acute graft-versus-host disease and pulmonary infection occurred after decitabine application combined with allogeneic hematopoietic stem cell transplantation. These findings suggest that decitabine application combined with allogeneic hematopoietic stem cell transplantation is an effective method to treat acute leukemia progressed from myelodysplastic syndrome, and the side effects and complications can be well controlled.