摘要
目的探讨替雷利珠单抗联合脐血移植在复发难治急性髓系白血病(AML)中的效果。方法回顾性分析2021年11月苏州大学附属第一医院收治的1例复发难治AML患者再诱导治疗失败后使用替雷利珠单抗桥接脐血移植的诊治过程。结果患者,男性,59岁,诊断为复发难治AML。初始予地西他滨+维奈克拉方案诱导化疗后达完全缓解,后予地西他滨+中剂量阿糖胞苷、中剂量阿糖胞苷+伊达比星等方案巩固治疗。16个月后疾病复发,先后予克拉屈滨+阿扎胞苷+维奈克拉联合化疗和高三尖杉酯碱+阿糖胞苷+粒细胞集落刺激因子方案再诱导化疗均未缓解,之后使用替雷利珠单抗治疗,肿瘤负荷明显降低,桥接脐血移植后获得完全缓解。移植后给予阿扎胞苷维持治疗。随访9个月,患者持续缓解,无严重移植相关并发症。结论替雷利珠单抗联合脐血移植挽救性治疗复发难治AML具有潜在应用价值。
Objective To explore the efficacy of tislelizumab combined with umbilical cord blood transplantation(UCBT)in relapsed/refractory acute myeloid leukemia(R/R AML)patients.MethodssThe diagnosis and treatment of 1 patient with R/R AML who received tislelizumab bridging to UCBT after the failure of re-induction treatment in the First Affiliated Hospital of Soochow University in November 2021 was retrospectively analyzed.Results The 59-year-old male patient with R/R AML achieved a complete remission after initial induction chemotherapy regimen of decitabine and venetoclax,and then additional consolidation therapy regimens of decitabine and middle-dose cytarabine,middle-dose cytarabine and idarubicin were performed.The patient relapsed 16 months later and failed to achieve a second remission after re-induction therapy regimens of cladribine,azacitidine;venetoclax combined with chemotherapy,and homoharringtonine,cytarabine combined with granulocyte colony-stimulating factor.Tislelizumab significantly reduced tumor burden and the patient achieved the complete remission after bridging to UCBT.After transplantation,the patient was given maintenance treatment with azacitidine and he had sustained remission without severe transplant-related complications during 9-month follow-up.Conclusions The use of tislelizumab bridging UCBT can be a potential therapeutic strategy for R/R AML patients.
作者
刘晨晨
周士源
朱倩
马超
马骁
吴德沛
吴小津
Liu Chenchen;Zhou Shiyuan;Zhu Qian;Ma Chao;Ma Xiao;Wu Depei;Wu Xiaojin(Department of Hematology,the First Affiliated Hospital of Soochow University,National Clinical Research Center for Hematologic Diseases,Jiangsu Institute of Hematology,Institute of Hematopoietic Stem Cell Transplantation,Soochow University,Collaborative Innovation Center of Hematology,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health,Suzhou 215006,China;Department of Hematology,Suzhou Hongci Hospital of Hematology,Suzhou 215100,China)
出处
《白血病.淋巴瘤》
CAS
2023年第3期161-165,共5页
Journal of Leukemia & Lymphoma
基金
国家自然科学基金(81974001、82170222、82171159)
国家科技重大专项(2017ZX09304021)
国家重点研发计划(2019YFC0840604、2017YFA0104502)
江苏省自然科学基金(BK20211070)
江苏省重点研发计划(BE2019798、BE2019656)
江苏省医学杰出人才项目(JCRCA2016002)
江苏省科教强卫工程-临床医学中心(YXZXA2016002)
苏州市科技计划(SLT201911)
苏州市临床重点病种诊疗技术专项(LCZX202101)。
关键词
白血病
髓样
急性
复发
难治
替雷利珠单抗
免疫疗法
挽救疗法
脐血干细胞移植
Leukemia,myeloid,acute
R
ecurrence
Refractory
Tislelizumab
Immunotherapy
Salvage therapy
Cord blood stem cell transplantation