期刊文献+
任意字段
题名或关键词
题名
关键词
文摘
作者
第一作者
机构
刊名
分类号
参考文献
作者简介
基金资助
栏目信息

AML行异基因造血干细胞移植后复发应用FLAG方案联合G-DLI的疗效研究

Observation curative effect of FLAG combination G-DLI for relapse of AML after allogeneic hematopoietic stem cell transplantation
下载PDF
导出
摘要 目的观察急性髓系白血病(AML)行异基因造血干细胞移植(allo-HSCT)后血液学复发,应用FLAG方案联合粒细胞集落刺激因子动员的供者淋巴细胞输注(G-DLI)治疗的临床疗效。方法对于接受异基因外周血造血干细胞移植(allo-PBSCT)后复发的患者,给予FLAG方案化疗后在白细胞降至最低点时给予G-DLI,观察白血病缓解及生存情况,并通过PubMed等检索进行文献复习。结果 3例移植术后复发接受FLAG方案联合G-DLI治疗者均再次获得完全缓解(CR)。1例G-DLI后无病存活(DFS)13个月,后出现中枢复发,但骨髓一直处于缓解状态,23个月后因多脏器功能衰竭死亡,总生存(OS)为23个月。GDLI后发生皮肤Ⅱ度急性高移植物抗宿主病(GVHD)及肝脏Ⅰ度急性GVHD,经处理后控制,未发生慢性GVHD。1例G-DLI后12个月再次骨髓复发,放弃治疗于1个月后死亡,DFS及OS分别为12、13个月。G-DLI后发生局限性皮肤慢性GVHD,给予小剂量免疫抑制剂后得到控制。1例G-DLI后无病存活至今,DFS为16个月。G-DLI后发生局限性皮肤慢性GVHD,给予小剂量免疫抑制剂后得到控制。结论 FLAG方案联合G-DLI可能是AML行allo-HSCT术后复发的有效治疗方式之一。 Objective To observe clinical curative effect of the FLAG regimen combined donor lymphocyte infusion after granulocyte colony stimulating factor（G-CSF）mobilization（G-DLI）,for the acute myeloid leukemia（AML）of allogeneic Peripheral blood hematopoietic stem cell trans-plantation（allo-HSCT）after recurrence of hematology.Methods For the patients with recurrence after allo-HSCT,giving the FLAG regimen chemotherapy when the WBC dropped to the lowest point,followed by giving GDLI that infusion peripheral blood stem cell from the original donors,to observe curative effect and survival situation.And searched the literature review through the PubMed etc.Results Through FLAG regimen combined G-DLI,3cases of relapse after transplantation again obtained complete remission（CR）.Case 1：disease-free survival（DFS）was 13 month and overall survival（OS）was 23 months after G-DLI.The patient has been the central recurrence and remission in bone marrow,he was dead after 23 months due to multipleorgan function failure.He occurred Ⅱ acute GVHD in Skin andⅠ acute GVHD in liver after G-DLI and obtained effective control,not chronic GVHD.Case 2：DFS and OS were 12 months and 13 months,as bone marrow relapse again and giving up treatment,so died a month later.Respectively,he has limitations chronic GVHD in skin after G-DLI.Case 3：DFS was 16 months after G-DLI since the disease-free survival,had limitations GVHD in skin that was control for given small dose of immunosuppressive drugs.Conclusion Joint FLAG scheme and G-DLI may be one of the effective treatment of postoperative recurrence of allo-HSCT.
作者 曹海洲 段显琳 袁海龙 曲建华 王蕾 徐建丽 王新有 刘颖 陈刚 古力巴旦木.艾则孜 江明
机构地区 新疆医科大学第一附属医院血液病中心/新疆维吾尔自治区血液病研究所
出处 《重庆医学》 CAS 北大核心 2015年第29期4045-4047,共3页 Chongqing medicine
关键词 白血病 髓细胞 急性 FLAG 供者淋巴细胞输注 leukemia myeloid acute FLAG donor lymphocyte infusion
分类号 R733.71 [医药卫生—肿瘤]
  • 相关文献

参考文献13

  • 1Pan L,Teshima T,Hill GR,et al.Granulocyte colony-stimulating factor-mobilized allogeneic stem cell transplantation maintains graft-versus-leukemia effects through a perforin-dependent pathway while preventing graft-versus-host disease[J].Blood,1999,93(12);4071-4078.
  • 2Choi SJ,Lee JH,Lee JH,et al.Treatment of relapsed a-cute myeloid leukemia after allogeneic bone marrow transplantation with chemotherapy followed by G-CSF-primed donor leukocyte infusion:a high incidence of isolated extr-amedullary relapse[J].Leukemia,2004,18(12):1789-1797.
  • 3Huang XJ,Wang Y,Liu DH,et al.Administration of shortterm immunosuppressive agents after DLI reduces the incidence of DLI-associated acute GVHD without influencing the GVL effect[J]_ Bone Marrow Transplant,2009,44(5):309-316.
  • 4Koistinen P,Raty RtItala M,et al.Long-term outcome of intensive chemotherapy for adults with de novo acute myeloid leukaemia(AML):the nationwide AML-92 study by the Finnish Leukaemia Group[J].Eur J Haematol,2007,78(6):477-486.
  • 5Auberger J,Clausen J,Willenbacher W,et al.Fludara-bine/intermediate-dose cytarabine with or without 'allogeneic hematopoietic stem cell transplantation in poor-risk leukemia:a single center experience[J].Int J Hematol,2008,87(4):382-386.
  • 6Kornguth DG,Mahajan A,Woo S,et al.Fludarabine allows dose reduction for total body irradiation in pediatric hematopoietic stem cell transplantation[J].Int J Radiat Oncol Biol Phys,2007,68(4):1140-1144.
  • 7George BV,Viswabandya A.Fludarabine-based reduced intensity conditioning regimens for allogeneic hematopoietic stem cell transplantion in patients with aplastic anemia and fungal infections[J].Clin Transplant,2009,23(2):228-232.
  • 8Neudorf S,Nourani A,Kempert P,et al.Chemotherapy and donor leukocyte infusions for relapsed juvenile my-elomonocytic leukemia(JMML)[J].Bone Marrow Transplant,2004,33(10):1069.
  • 9Komori T,Sugiyama H,Ogawa H i et al.Treatment of a patient in a relapse after bone marrow transplantation for acute lymphoblastic leukemia with the systemic administration of allogeneic lymphokine-activated killer cells and recombinant interleukin-2[J].Eur J Haematol,1989,43(2):184-185.
  • 10Porter DL,Collins RH? Hardy C,et al.Treatment of relapsed leukemia after unrelated donor marrow transplantation with unrelated donor leukocyte infusions[J].Blood,2000,95(4):1214-1221.

二级参考文献22

  • 1陈瑶,陆道培,刘开彦,董陆佳,任汉云,黄晓军,陈欢,刘代红,江倩,陈育红,许兰平,张耀臣,路瑾,高志勇.异基因造血干细胞移植后急性移植物抗宿主病151例危险因素分析[J].中华血液学杂志,2005,26(2):74-77. 被引量：29
  • 2Bethge WA, Faul C, Bornh:iuser M, et al. Haploidentical alloge- neic hematopoietic cell transplantation in adults using CD3/ CD19 depletion and reduced intensity conditioning: an update [ J ]. Blood Cells Mol Dis, 2008,40 ( 1 ): 13-19.
  • 3Huang X J, Liu DH, Liu KY, et al. Haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion for the treatment of hematological malignancies [J]. Bone Marrow Transplant, 2006, 38(4) :291-297.
  • 4Lu DP, Dong L,Wu T, et al. Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploi- dentical blood and marrow transplantation can achieve compara- ble outcomes with HLA-identical sibling transplantation [Jl. Blood,2006,107 ( 8 ) :3065-3073.
  • 5Thomas ED, Storb R, Clift RA, et al. Bone marrow transplanta- tion[J]. N Eng J Med[J], 1975, 292( 17):895-902.
  • 6Hansen JA, Petersdorf E, Martin P J, et al. Hematopoietic stem cell transplants from unrelated donors [J]. Immunol Rev, 1997, 157:141-151.
  • 7Powles RL,Morgenstem GR,Kay HE,et al. Mismatched family donors for bone-marrow transplantation as treatment for acute leukemia [ J ]. Lancet, 1983,1 ( 8325 ) : 612-615.
  • 8Aversa F, Tabilio A, Terenzi, et al. Successful engraftment of T cell-depleted haploidentical three-loc incompatible transplants in leukemia patients by addition of recombinant human granulocyte colony-stimulating Factor-mobilized peripheral blood progenitor cells to bone marrow inoculum [J]. Blood, 1994,84( 11 ):3948-3955.
  • 9Handgretinger R,Chen X,Pfeiffer M,et al. Feasibility and out- come of reduced- intensity conditioning in haploidentical trans- plantation[J]. Ann N Y Acad Sci,2007,1106:279-289.
  • 10Di Bartolomeo P, Santarone S, De Angelis G, et al. Haploidenti- cal, unmanipulated, G-CSF-primed bone marrow transplanta- tion for patients high-risk hematologic malignancies. Blood, 2013,121(5):849-857.

共引文献9

重庆医学
2015年 第29期

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部