造血干细胞移植治疗Ph样急性淋巴细胞白血病五例报道并文献复习
Hematopoietic stem cell transplantation for Ph-like acute lymphoblastic leukemia and literature review
目的 分析造血干细胞移植治疗五例费城染色体(Ph)样急性淋巴细胞白血病(ALL)的疗效.方法 采用荧光原位杂交(FISH)检测Ph样ALL常见基因重排.予化疗联合芦可替尼诱导治疗,未缓解的患者接受嵌合抗原受体T(CAR-T)细胞治疗,在获得完全缓解(CR)后行造血干细胞移植(HSCT).其中4例受者接受异基因HSCT,1例受者接受自体HSCT.结果 化疗联合芦可替尼治疗后,3例获得完全缓解,2例未缓解的受者接受CAR-T治疗,并获得完全缓解.4例受者移植后处于持续完全缓解,1例受者移植后早期复发.结论 联合传统化疗、芦可替尼和CAR-T等综合治疗手段使患者尽快达CR,并序贯HSCT,有望改善此类患者的预后.
更多Objective To explore the efficacy of hematopoietic stem cell transplantation (HSCT) for 5 patients with Ph-like acute lymphoblastic leukemia (ALL).Methods Fluorescent in situ hybridization (FISH) was performed for detecting the rearrangement of susceptibility genes.Combined therapy of chemotherapy and ruxolitinib were applied,followed by HSCT.Those failing to achieve complete remission (CR) received an infusion of chimeric antigen T-cells (CAR-T),followed by HSCT once CR was achieved.Four patients accept allogenic HSCT while another auto HSCT.Results Three of them achieved CR after chemotherapy and ruxolitinib.The remaining 2 patients got CR after CAR-T.Four patients remained in CR after HSCT.Early relapse occurred in 1 patient after HSCT.Conclusions Combined therapy of chemotherapy,ruxolitinib and CAR-T are necessary for Phlike ALL patients.HSCT after an initial CR improve patient prognosis.
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