替雷利珠单抗桥接脐血移植治疗复发难治急性髓系白血病1例并文献复习

Tislelizumab bridging to umbilical cord blood transplantation therapy for relapsed/refractory acute myeloid leukemia:report of 1 case and review of literature

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.