异基因造血干细胞移植治疗首例自体移植复发霍奇金淋巴瘤的临床分析  

Clinical Analysis of Allogeneic Hematopoietic Stem Cell Transplantation for Hodgkin's Lymphoma First Autologous Stem Cell transplant Relapse

作　　者：郭智[1] 陈惠仁[1] 刘晓东[1] 楼金星[1] 何学鹏[1] 

机构地区：[1]北京军区总医院血液科,100700

出　　处：《实用癌症杂志》2012年第5期478-481,共4页The Practical Journal of Cancer

基　　金：广西卫生厅自筹经费科研课题基金(编号:Z2011229)

摘　　要：目的探讨霍奇金淋巴瘤自体移植复发后行异基因造血干细胞2次移植的可能性和安全性。方法对1例10年前行自体造血干细胞移植复发的霍奇金淋巴瘤患者,行异基因造血干细胞移植,供者为患者母亲,采用外周血干细胞移植,预处理方案采用氟达拉滨+马法兰+兔抗人淋巴细胞免疫球蛋白,预防移植物抗宿主病采用环孢素A、霉酚酸酯、甲氨蝶呤,输注单个核细胞数14.03×108/kg,CD34+细胞6.57×106/kg。结果 2次移植后移植物成功植入,形成完全供者来源造血,移植后第20天骨髓初步植活,造血功能恢复后患者出现皮肤植物抗宿主病,FISH嵌合状态供者细胞植入率为100%,随访至今一直长期无病生存。结论异基因造血干细胞移植,可有效治疗自体移植复发的霍奇金淋巴瘤,是安全有效的挽救治疗措施。Objective To investigate the possibility and security of Hodgkin’s lymphoma with autologous transplantation relapse treated with allogeneic hematopoietic stem cell transplantation for the second time.Methods A case of autologous hematopoietic stem cell transplant relapse of Hodgkin’s lymphoma patients first treated 10 years ago was treated with allogeneic hematopoietic stem cell transplantation,donor was the patient’s mother,using blood stem cell transplantation,conditioning regimen was fudalabin Melphalan anti-thymocyte globulin.Prevention of graft-versus-host disease with cyclosporin A,mycophenolate mofetil,methotrexate.Infusion of the mononuclear cell 14.03×108/kg,CD34＋ cells 6.57×106/kg.Results The second post-transplant graft was successfully implanted to form a complete source of donor hematopoietic and immune function after second hematopoietic stem cell transplantation.Patients had skin graft-versus-host disease after hematopoietic recovery,20 days later the second transplant of bone marrow preliminary engraftment and follow-up has been a long-term disease-free survival.Conclusion Allogeneic hematopoietic stem cell transplantation therapy is a safe and effective treatment for autologous transplantation recurrence of Hodgkin’s lymphoma.

关 键 词：霍奇金淋巴瘤 自体 异基因 造血干细胞移植 

分 类 号：R733.1[医药卫生—肿瘤]