Management of relapsed cutaneous T-Cell lymphoma following allogeneic hematopoietic stem cell transplantation: Review with representative patient case.
Management of relapsed cutaneous T-Cell lymphoma following allogeneic hematopoietic stem cell transplantation: Review with representative patient case.
复制标题
同种异体造血干细胞移植后复发性皮肤 T 细胞淋巴瘤的治疗：回顾代表性患者病例。
DOI：
10.1111/dth.15538
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发表时间：
2022
影响因子：
3.6
通讯作者：
Kim,EllenJ
中科院分区：
文献类型：
--
作者：
Weiner,DavidM;Lewis,DanielJ;Spaccarelli,NatalieG;Clark,RachaelA;Nasta,SunitaD;Loren,AlisonW;Rook,AlainH;Kim,EllenJ
异基因造血干细胞移植（allo‐HSCT）是难治性皮肤T细胞淋巴瘤（CTCL）患者的一种潜在治愈性治疗选择，通过替代负责淋巴瘤细胞的骨髓并可能诱导移植物抗淋巴瘤效应。然而，allo-HSCT并不总是治愈的;大约一半的患者在移植后发生CTCL复发。allo HSCT后复发性CTCL的治疗具有挑战性，因为移植后患者的移植物抗宿主病风险较高，标准CTCL治疗可能会加重或加重这种疾病。因此，每种潜在疗法的益处必须与其移植物抗宿主病（GVHD）的风险相权衡。在这篇文章中，我们回顾了allo‐HSCT后复发性CTCL的管理。我们开始以一名典型患者为例，该患者的复发性塞扎里综合征得到成功治疗，未发生GVHD。我们还报告了在患者疾病复发和缓解期间获得的高通量T细胞受体测序数据。然后，我们回顾了复发性CTCL管理的一般指南，并总结了移植后复发性CTCL的所有报告病例和结局。最后，我们回顾了目前的CTCL治疗及其GVHD的风险。
Allogeneic hematopoietic stem cell transplantation (allo‐HSCT) is a potentially curative treatment option for patients with refractory cutaneous T‐cell lymphoma (CTCL) through replacement of the bone marrow responsible for lymphoma cells and possibly induction of a graft‐versus‐lymphoma effect. However, allo‐HSCT is not always curative; relapse of CTCL occurs in about half of patients post‐transplant. Treatment of relapsed CTCL after allo‐HSCT is challenging because post‐transplant patients are at high risk of graft‐versus‐host disease, and this condition may be precipitated or exacerbated by standard CTCL therapies. The benefit of each potential therapy must therefore be weighed against its risk of graft versus host disease (GVHD). In this article, we review the management of relapsed CTCL after allo‐HSCT. We begin with an exemplative patient whose relapsed Sezary syndrome was successfully treated without development of GVHD. We also report high‐throughput T‐cell receptor sequencing data obtained during the patient's disease relapse and remission. We then review general guidelines for management of relapsed CTCL and summarize all reported cases and outcomes of relapsed CTCL after transplant. We conclude by reviewing the current CTCL therapies and their risk of GVHD.