地西他滨联合化疗治疗伴TP53突变T淋巴母细胞淋巴瘤/白血病异基因造血干细胞移植后复发1例并文献复习

Decitabine combined with chemotherapy in treatment of relapsed T lymphoblastic lymphoma/leukemia with TP53 mutation after allogeneic hematopoietic stem cell transplantation:report of 1 case and review of literature

目的观察地西他滨联合化疗在复发难治伴TP53突变T淋巴母细胞淋巴瘤/白血病(T-LBL/ALL)患者中的疗效及安全性。方法回顾性分析苏州大学附属第一医院2018年6月收治的1例接受地西他滨联合化疗治疗的伴TP53突变T-LBL/ALL异基因造血干细移植(allo-HSCT)后复发患者的临床资料,并复习相关文献。结果患者为42岁男性,综合检查后确诊为伴TP53突变T-LBL/ALL,第2次完全缓解后行同胞全相合allo-HSCT,移植后8个月复发,行地西他滨联合CLAG方案化疗达完全缓解,后予地西他滨维持治疗,持续无白血病生存。结论对于allo-HSCT后复发的伴TP53突变T-LBL/ALL患者,地西他滨联合化疗可能是一种安全有效的治疗选择。

Objective To observe the efficacy and safety of decitabine combined with chemotherapy in treatment of relapsed/refractory T lymphoblastic lymphoma/leukemia(T-LBL/ALL)with TP53 mutation.Methods The clinical data of a T-LBL/ALL patient with TP53 mutation who had recurrence after allogeneic hematopoietic stem cell transplantation(allo-HSCT)treated with decitabine combined with chemotherapy in the First Affiliated Hospital of Soochow University in June 2018 were retrospectively analyzed and the relevant literature was reviewed.Results The patient,a 42-year-old male,diagnosed as T-LBL/ALL with TP53 mutation by comprehensive examination underwent sibling-matched donor allo-HSCT after a second complete remission.The patient relapsed 8 months later and was treated with decitabine combined with CLAG regimen to achieve complete remission again.And then,he had leukemia-free survival until now through maintenance treatment with decitabine.Conclusion Decitabine combined with chemotherapy may be a safe and effective treatment option for relapsed T-LBL/ALL patients with TP53 mutation after allo-HSCT.