化疗联合G-CSF动员造血干细胞输注治疗移植后EB病毒相关淋巴增值性疾病1例分析  

Conquer Epstein-Barr virus associated post-transplant lymphoproliferative disorder(EBV-PTLD)with chemotherapy and following donor peripheral blood stem cell infusion:a case report and literature review

作　　者：王瑶[1] 石威[1] 王华芳[1] 陆铉 夏淩辉 游泳[1] 仲照东[1] 胡豫[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院血液病研究所,武汉430022

出　　处：《临床血液学杂志》2015年第3期412-416,共5页Journal of Clinical Hematology

基　　金：国家自然基金青年基金(No:81302043)

摘　　要：目的:异基因造血干细胞移植后EB病毒(EBV)相关性淋巴增殖性疾病(EBV-PTLD)是造血干细胞移植和实体器官移植后一种少见但致命的并发症。本研究对1例重型再生障碍性贫血(SAA)患者移植后EBV相关性PTLD的治疗进行了探索,期望为PTLD的治疗提供新的思路。方法:1例17岁男性SAA患者在我院行单倍体移植后第133天被诊断为EBV-PTLD,给予MEA方案化疗配合供者外周血造血干细胞输注治疗。结果:患者完成治疗后第20天复查外周血EBV-DNA为阴性,第80天全身PET提示全身病灶控制良好,观察至今无复发。结论:化疗联合造血干细胞输注为治疗EBV-PTLD的有效方法,但其长期预后需要进一步的研究来证实。Objective：Epstein-Barr virus associated post-transplant lymphoproliferative disorder （EBV-PTLD） is an extremely rare but fatal complication of hematopoietic stem cell or solid organ transplantation. This research explored the therapy of a patient with severe aplastic anemia undergone hematopoietic stem cell transplantation followed by EBV-PTLD. It is expected to be a new strategy for EBV-PTLD. Method： A 17-year-old SAA patient was diagnosed with EBV-PTLD after receiving the hapIo allergic hematopoietic stem cell transplantation on the ＋ 133 d. We then treated him with MEA chemotherapy regimen followed by infusion of donor peripheral blood stem cell. Result ： The EBV-DNA in peripheral blood was negative and the whole body PET-CT showed PTLD CR until now. Conclusion：Combination chemotherapy and infusion donor peripheral blood stem ceil infusion was an effective ther- apeutic method for EBV-PTLD,however,the long-term prognosis is need to be confirmed.

关 键 词：造血干细胞移植 EB病毒 淋巴增殖性疾病 化疗 

分 类 号：R457.7[医药卫生—治疗学]