不同类型恶性血液病异基因造血干细胞移植后发生T-LGL临床特征及预后分析

Clinical Features and Prognosis of T-LGL After allo-HSCT for Different Types of Malignant Hematologic Diseases

目的探讨不同类型血液病异基因造血干细胞移植(allo-HSCT)后发生T大颗粒淋巴细胞增多(T-LGL)的临床特征及预后的特点。方法回顾性分析9例不同类型血液病在苏州大学附属第一医院接受allo-HSCT后发生T-LGL患者的临床及实验室资料,包括一般信息、移植类型、LGL比例及持续时间,通过分类对比预后等,对结果进行总结。结果该研究共纳入9例患者,其中AA 1例,AML 3例,ALL 4例,HAL 1例,中位年龄为28岁。移植后T-LGL起始时间不等,中位T-LGL起始时间AA为11.5个月,HAL为1.3个月,ALL为16.9(3.2~46.5)个月,AML为10.9(6.9~21.0)个月。随访时间截止至2021年12月31日,中位T-LGL持续时间AA为45.2个月,ALL为31.2(7.2~73.5)个月,AML为19.2(15.7~32.4)个月,HAL为26.3个月。预后AML、AA、ALL共8例患者均无病生存,无需针对T-LGL特殊治疗,HAL 1例死于复发。结论不同类型血液病allo-HSCT后可发生T-LGL,多数为移植后良性反应,但并不总是代表良好的预后。

Objective To investigate the clinical features and prognosis of T-granular lymphocytosis(T-LGL)after allo-HSCT for different types of malignant hematologic diseases.Methods The clinical and laboratory data including general information,transplant type and LGL duration,of 9 patients with T-LGL after allo-HSCT in the First Affiliated Hospital of Soochow University,were retrospectively analyzed,and the results were summarized by classifying and comparing the prognosis.Results 9 patients included 1 case AA,3 cases AML,4 cases ALL and 1 case HAL(median age:28 years).After transplantation,the median initiation time of T-LGL ranged from 11.5 months for AA,1.3 months for HAL,16.9(3.2-46.5)months for ALL,and 10.9(6.9-21.0)months for AML.The follow-up period ended on December 31,2021,the median duration of T-LGL was 45.2 months for AA,31.2(7.2-73.5)months for ALL,19.2(15.7-32.4)months for AML,and 26.3 months for HAL.8 patients with AML,AA and ALL survived without disease,without specific treatment for T-LGL,and 1 patient with HAL died of recurrence.Conclusion T-LGL can occur after allo-HSCT for different types of hematopoietic diseases,most of which are benign reactions,but do not always represent a good prognosis.