异基因造血干细胞移植治疗淋巴瘤合并HLH预处理方案的研究  

Study on the pretreatment schemes of allogeneic hematopoietic stem cell transplantation for lymphoma with HLH

作　　者：赵鹏 张燕 李艳菊 李梦醒 詹云 李燕 陈莹 柴笑 黄懿 刘敏 张奉齐 黄诗思 赵梅 倪明 王季石 ZHAO Peng;ZHANG Yan;LI Yanju;LI Mengxing;ZHAN Yun;LI Yan;CHEN Ying;CHAI Xiao;HUANG Yi;LIU Min;ZHANG Fengqi;HUANG Shisi;ZHAO Mei;NI Ming;WANG Jishi(Department of Hematology,the Affiliated Hospital of Guizhou Medical University/Guizhou Hematopoietic Stem Cell Transplantation Center,Guiyang,Guizhou 550004,China)

机构地区：[1]贵州医科大学附属医院血液科/贵州省造血干细胞移植中心,贵阳550004

出　　处：《重庆医学》2020年第15期2491-2494,共4页Chongqing medicine

基　　金：贵州省科技计划项目(黔科合LH字[2017]7216号)。

摘　　要：目的观察复发难治淋巴瘤合并噬血细胞综合征(HLH)采用异基因造血干细胞移植(alloSCT)的临床疗效。方法选取2017年10月至2019年10月于该院血液科随访接受alloSCT的19例复发难治淋巴瘤合并HLH患者为研究对象,所有患者均未检测出HLH相关遗传学缺陷,移植前12例患者存在EB病毒血症。19例患者中5例为同胞全合alloSCT,其余14例为同胞半相合alloSCT,所有患者预处理方案均使用依托泊苷。对移植后EB病毒载量、移植物抗宿主病(GVHD)、移植相关死亡率(TRM)及总体生存率(OS)进行统计分析。结果所有患者全部植活,均获得造血重建,移植后持续EB病毒血症为58.3%(7/12),GVHD发生率为47.4%(9/19),移植后100 d内TRM为10.5%,移植后100 d至1年内TRM为23.5%(4/17)。结论alloSCT是目前治疗复发难治淋巴瘤合并HLH有效的治疗手段。Objective To observe the clinical efficacy of allogeneic hematopoietic stem cell transplantation(alloSCT)in the treatment of lymphoma associated hemophagocytic lymphohistiocytosis(HLH).Methods A total of 19 patients with relapsed and refractory lymphoma and HLH who underwent alloSCT in the hematology department from October 2017 to October 2019 were selected.All the patients did not detect HLH-related genetic defects,12 patients before transplantation presented with EB virusemia.Five cases were sibling alloSCT,the other 14 cases were haploidentical alloSCT,etoposide was used for pretreatment protocols in all patients.The EB virus load,graft-versus-host disease(GVHD),transplant-related mortality(TRM),and overall survival rate(OS)were statistically analyzed.Results All the patients were transplanted and hematopoietic reconstruction was obtained.Sustained EB virusemia was 58.3%(7/12)after transplantation,and the incidence of GVHD was 47.4%(9/19),TRM was 10.5%(2/19)within 100 days to 1 year after transplantation.TRM was 0 within 100 days of transplantation,while TRM was 23.5%(4/17)from 100 days to 1 year after transplantation.Conclusion AlloSCT is currently an effective treatment for relapsed and refractory lymphoma with HLH.

关 键 词：造血干细胞移植 淋巴组织细胞增多症 嗜血细胞性 淋巴瘤 依托泊甙 

分 类 号：R557.4[医药卫生—血液循环系统疾病]