异基因造血干细胞移植后EB病毒相关性淋巴组织增殖性疾病的临床分析  

Clinical analysis of EB virus associated post-transplant lymphoproliferative disorder after allogeneic hematopoietic stem cell transplantation

作　　者：古再丽努尔·吾甫尔[1] 杨栋林[2] 冯四洲[2] 韩明哲[2] 

机构地区：[1]新疆维吾尔自治区人民医院血液病科,乌鲁木齐830001 [2]中国医学科学院,北京协和医学院血液学研究所,血液病医院骨髓移植诊治中心

出　　处：《临床血液学杂志》2017年第2期225-228,共4页Journal of Clinical Hematology

基　　金：天津市应用基础与前沿技术研究计划(No:14JCZDJC33000)

摘　　要：移植后淋巴增殖性疾病（post-transplant lymphoproliferative disorders,PTLD）是器官和造血干细胞移植后的严重并发症之一,PTLD在异基因造血干细胞移植（allo-HSCT）中发生率为0~25%,几乎所有的早期PTLD与EBV病毒感染有关,高发于去T细胞移植或预处理方案中采用抗胸腺细胞球蛋白（ATG）、无关和半相合移植患者中。To improve the understanding of EB virus associated post-transplant lymphoproliferative disorder （EBV-PTLD） after allogeneic hematopoietic stem cell transplantation,and to explore the early diagnosis and treat- ment of EBV-PTLD. The clinical data of 2 cases of acute lymphoblastic leukemia patients who had EBV-PTLD after unrelated donor transplantation were reported. Both of them were pretreated with TBI＋CTX＋Flu＋ Ara-C＋ATG （rabbit） before unrelated donor transplantation. EBV-DNA increment, fever and lymphadenectasis occurred on day 41th and day 67th after transplantation respectively. The two patients received the preemptive therapy of reduction of CsA and application of rituximab. All clinical symptoms were completely disappeared. Dynamic monito- ring of EBV-DNA is important for patients with high risk factors of EBV-PTLD. The prognosis of EBV-PTLD can be improved by early application of rituximab and the reduction of immunosuppression.

关 键 词：EB病毒 移植后淋巴组织增殖性疾病 造血干细胞移植 利妥昔单抗 

分 类 号：R551.2[医药卫生—血液循环系统疾病]