急性白血病异基因造血干细胞移植后髓外复发8例临床分析  

Outcome of extramedullary relapse with acute leukemia after allogeneic hematopoietic stem cell transplantation:8 cases report

作　　者：刘丹波[1] 王志东[2] 郑晓丽[2] 邵群[2] 王勇奇[2] 董磊[2] 丁丽[2] 阎洪敏[2] 王恒湘[2] 

机构地区：[1]大连医科大学 [2]空军总医院血液科

出　　处：《临床血液学杂志》2014年第3期414-417,共4页Journal of Clinical Hematology

摘　　要：目的：探讨急性白血病异基因造血干细胞移植（Allo-HSCT）后髓外复发的危险因素、临床表现及治疗方法。方法：回顾性分析急性白血病Allo-HSCT后出现髓外复发的8例患者的临床资料。结果：8例患者髓外复发的中位时间为移植后4（2-57）个月。复发部位以软组织为主,其次为中枢神经系统和锁骨上淋巴结。8例患者中7例存在高危因素,包括发病时白细胞数高者3例,染色体异常者6例,4例急性粒细胞白血病患者CD56^＋,2例为难治性白血病。除1例放弃治疗外,其余7例均接受供者淋巴细胞输注、化疗、局部放疗和手术等治疗。8例患者均已死亡,死亡中位时间为髓外复发后3个月。结论：急性白血病Allo-HSCT后髓外复发与移植时疾病状态有关。目前对髓外复发仍缺乏有效的治疗方法,整体预后较差。Objective：To analyze the risk factors,clinical manifestations and treatment of extramedullary relapse with acute leukemia after allogeneic hematopoietic stem cell transplantation（Allo-HSCT）.Method：We retrospectively analyzed outcomes of 8patients with acute leukemia who had extramedullary relapse after Allo-HSCT. Result：The median time from transplantation to extramedullary relapse was 4months（2to 57months）.The most frequent relapse site was in the soft tissue,followed by the central nervous system and supraclavicular lymph nodes.Seven of 8patients had risk factors including hyperleukocytic（3cases）,chromosomal abnormalities（6cases）,CD56highly expressed（4cases）and refractory leukemia（2cases）.Seven cases received first-line salvage included donor lymphocyte infusion,chemotherapy,radiation therapy,chemotherapy and surgery.All patients had died with the median time to death was 3months after extramedullary relapse.Conclusion：Our data provide more insight into the disease behavior for patients with acute leukemia who have extramedullary relapse after AlloHSCT.The treatment outcomes are limited and the overall prognosis is poor.

关 键 词：白血病 急性 异基因造血干细胞移植 髓外复发 

分 类 号：R733.71[医药卫生—肿瘤]