CAG预激方案治疗合并镰刀菌感染的成年人早期前体T细胞急性淋巴细胞白血病1例并文献复习  

CAG stimulating regimen in treatment of adult early T cell precursor acute lymphoblastic leukemia complicated with fusarium infection:report of 1 case and review of literature

作　　者：王聪[1] 张高玲 杜忠华[1] 韩薇[1] 赵晓霞 高素君[1] 刘秋菊[1] Wang Cong;Zhang Gaoling;Du Zhonghua;Han Wei;Zhao Xiaoxia;Gao Sujun;Liu Qiuju(Department of Hematology,the First Hospital of Jilin University,Jilin 130021,China)

机构地区：[1]吉林大学第一医院血液科,长春130021

出　　处：《白血病．淋巴瘤》2023年第3期166-170,共5页Journal of Leukemia & Lymphoma

摘　　要：目的探讨CAG预激方案治疗合并镰刀菌感染的难治成年人早期前体T细胞急性淋巴细胞白血病(ETP-ALL)的效果,及皮肤镰刀菌感染的临床特点和抗真菌治疗策略。方法回顾性分析2020年9月吉林大学第一医院收治的1例合并皮肤镰刀菌感染的ETP-ALL成年患者的诊疗过程,并复习相关文献。结果该患者接受VICP方案化疗无效,长期粒细胞缺乏并发典型皮肤镰刀菌感染,经两性霉素B治疗感染稳定后,给予CAG预激方案成功挽救治疗,予以髓系方案为主的巩固治疗达到微小残留病阴性,后续顺利进行单倍体异基因造血干细胞移植,过程中持续口服泊沙康唑。结论CAG预激方案可作为复发难治ETP-ALL的再诱导治疗方案;两性霉素B序贯泊沙康唑可作为镰刀菌感染的抗真菌治疗策略。Objective To investigate the clinical effect of CAG stimulating regimen for refractory adult early T cell precursor acute lymphoblastic leukemia(ETP-ALL)complicated with fusarium infection and the clinical features as well as antifungal strategy of cutaneous fusarium infection.Methods The diagnosis and treatment of 1 adult patient diagnosed as ETP-ALL complicated with cutaneous fusarium infection in the First Hospital of Jilin University in September 2020 were retrospectively analyzed,and related literatures were reviewed.Results VICP chemotherapy regimen showed no effectiveness in this patient who was presented with persistent agranulocytosis complicated with cutaneous fusariosis infection.After amphotericin B therapy for infection,he achieved the stable disease and successfully underwent CAG stimulating regimen salvage treatment.The minimal residual disease turned into negative after consolidation chemotherapy based on the myeloid regimen,Finally this patient survived from haploid allogeneic hematopoietic stem cell transplantation after consolidation chemotherapy and fusarium was under the control by using posaconazole as secondary prevention therapy.Conclusions CAG stimulating regimen can be recommended as reinduction therapy for relapsed/refractory ETP-ALL.Sequential therapy of amphotericin B followed by posaconazole can be a useful antifungal strategy for fusarium infection.

关 键 词：白血病 T淋巴细胞 急性 镰刀菌属 复发 药物疗法 联合 

分 类 号：R733.71[医药卫生—肿瘤]