单倍体相合移植治疗自体移植后复发的原发骨霍奇金淋巴瘤1例并文献复习  

Haploidentical hematopoietic stem cell transplantation in patients with aggressive and refractory primary bone Hodgkin lymphoma:A case report and review of literatures

作　　者：薛梅[1] 丁利[1] 朱玲[1] 刘静[1] 董磊[1] 闫洪敏[1] 王志东[1] 王恒湘[1] 

机构地区：[1]空军总医院血液科,北京100142

出　　处：《临床血液学杂志》2013年第1期26-28,共3页Journal of Clinical Hematology

摘　　要：目的:探讨单倍体相合造血干细胞移植治疗自体移植后复发的难治性骨霍奇金淋巴瘤的可行性。方法:报道1例原发性骨霍奇金淋巴瘤患者的诊断、治疗和移植经过,结合文献复习,提高对该病的认识。结果:该患者初诊为骨结核,抗结核治疗无效,经病变局部活检最终确诊为原发骨霍奇金淋巴瘤,多个疗程化疗缓解并自体造血干细胞移植,移植后4个月复发。经多疗程含硼替佐米的联合化疗方案挽救治疗再次达完全缓解,继而行单倍体相合造血干细胞移植,植入成功,造血重建,中性粒细胞>0.5×109/L及血小板>20×109/L的平均时间分别为13d及19d,植入鉴定证实为供者型。移植后6个月PET/CT显示病灶无活动。结论:原发性骨霍奇金淋巴瘤是极少见的淋巴瘤,早期诊断困难,确诊主要临床特征、影像学及病理检查,放化疗是常规治疗手段。对难治或自体造血干细胞移植后复发年轻患者,选择含硼替佐米的联合化疗方案作为其挽救治疗,随后行单倍体相合造血干细胞移植,方法可行,国内外未见类似报道。Objective：To investigate the effect of haploidentical hematopoietic stem cell transplantation in a patient with aggressive and refractory primary bone lymphoma（PBL） who relapsed following autologous stem cell transplant（ASCT）.Method：A case of PLB was reported with emphasis on clinical date,diagnosis,treatment and the follow-up results.The related literatures were also reviewed.Result：The patient with the first symptom of pain on the local bone was diagnosis as bone thberculosis.Sinse the patient had no responds to antituberculous treatment,tissue biopsy of the lesion was performed,and according to which the diagnosis of PBL were established.He achieved complete remission with chemotherapy and then treated by ASCT.After relapsing four months later,he received a few cycles of chemotherapy combinationed with bortezomib and achieved complete remission again,and then the haploidentical hematopoietic stem cell transplantation was given.The results after transplation indicated that the stem cells were engrafted and showed reconstruction of hematopoiesis.The median time of granulocytes exceeding 0.5×109/L and platelet s exceeding 20×109/L were 13 day and 19 day.He had 100% donor hematological cell after transplantation by cytogenetic evidence analysis.The result of positron emission tomography（PET） scan continues to be negative within six month after hematopoietic stem cell transplantation.Conclusion：The PBL is an extremely rare malignant bone tumor.The diagnosis is difficult because of its non-specific clinical manifestations in the early stage.The clinical features,imaging features,characteristics of histopathological and immunohistochemistry examinations can lead to the diagnosis.The combination of chemotherapy and radiotherapy was the optimal treatment for patients with PBL.The Bortezomib will be as a salvage options to improve induction therapy for high-risk patients with aggressive or refractory PBL relapsed after ASCT.And the haploidentical hematopoietic stem cell transplantation for the trea

关 键 词：淋巴瘤 霍奇金 原发性 造血干细胞移植 单倍体相合 

分 类 号：R733.4[医药卫生—肿瘤]