Denileukin diftitox and hyper-CVAD in the treatment of human T-cell lymphotropic virus 1-associated adult T-cell leukemia/lymphoma
Denileukin diftitox and hyper-CVAD in the treatment of human T-cell lymphotropic virus 1-associated adult T-cell leukemia/lymphoma
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DOI：
10.3816/clm.2003.n.027
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发表时间：
2003-12-01
期刊：
影响因子：
--
通讯作者：
Foss, F
中科院分区：
文献类型：
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作者：
DiVenuti, G;Nawgiri, R;Foss, F
我们报告一例人类T细胞嗜淋巴病毒1型（HTLV-1）相关成人T细胞白血病/淋巴瘤（ATL）患者，在接受地尼白介素Diftitox和hyper-CVAD（超分割环磷酰胺/多柔比星/长春新碱/decadron）治疗后临床缓解> 1年。患者表现为白细胞增多、贫血和血小板减少，骨髓活检显示广泛的骨髓纤维化和白血病T细胞浸润。初始治疗4个周期的地尼白介素diftitox导致恢复正常的造血和减少骨髓骨髓纤维化。在疾病进展后，给予4个周期的hyper-CVAD，并达到完全临床缓解。患者保持无疾病，造血功能正常，并继续使用地尼白介素diftitox维持治疗1年。该病例证明了地尼白介素diftitox给药后骨髓纤维化和急性T细胞白血病的临床改善，表明地尼白介素diftitox可能影响HTLV-1相关ATL临床表现的旁分泌。
We report a case of human T-cell lymphotropic virus 1 (HTLV-1)-associated adult T cell leukemia/lymphoma (ATL) in clinical remission > 1 year after therapy with denileukin diftitox and hyper-CVAD (hyperfractionated cyclophosphamide/doxorubicin/vincristine/decadron). The patient presented with leukocytosis, anemia, and thrombocytopenia, and bone marrow biopsy demonstrated extensive myelofibrosis and infiltration with leukemic T cells. Initial therapy with 4 cycles of denileukin diftitox resulted in restoration of normal hematopoiesis and a reduction in bone marrow myelofibrosis. After disease progression, 4 cycles of hyper-CVAD were administered and a complete clinical remission was achieved. The patient remains free of disease with normal hematopoiesis and has continued maintenance therapy with denileukin diftitox for 1 year. This case demonstrates clinical improvement of myelofibrosis and acute T-cell leukemia after denileukin diftitox administration, suggesting that denileukin diftitox may affect the paracrine secretion of HTLV-1 -associated clinical manifestations of ATL.