Durable Leukemic Remission and Autologous Marrow Recovery with Random Chromosomal Abnormalities after Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia

Durable Leukemic Remission and Autologous Marrow Recovery with Random Chromosomal Abnormalities after Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia
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慢性淋巴细胞白血病同种异体造血干细胞移植后随机染色体异常的持续白血病缓解和自体骨髓恢复

DOI:
10.1155/2019/9710790
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发表时间:
2019
影响因子:
0.7
通讯作者:
Chiba Shigeru
Chiba Shigeru
中科院分区:
--
文献类型:
--
作者:
Nishikii Hidekazu;Kurita Naoki;Shinagawa Atsushi;Sakamoto Tatsuhiro;Kusakabe Manabu;Yokoyama Yasuhisa;Kato Takayasu;Sakata-Yanagimoto Mamiko;Obara Naoshi;Hasegawa Yuichi;Nakamura Naoya;Chiba Shigeru

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对1例慢性淋巴细胞白血病(CLL)侵袭性临床病程的38岁女性患者进行了8个疗程的R-CHOP治疗。临床缓解,而B细胞克隆性保持不变。异基因造血干细胞移植采用低强度预适应(氟达拉滨+2Gy全身照射)。然而,移植后一个月内发生了自体造血恢复。然而,移植后14天无法检测到B细胞克隆性,这种情况已经保持了10多年,临床症状有所缓解。细胞遗传学分析反复进行,显示非克隆性染色体异常,尽管患者没有发生任何继发性恶性肿瘤。临床病程的一种可能解释是一种非常短期的同种异体免疫反应,有助于根除残留的CLL细胞。
A 38‐year‐old woman with aggressive clinical course of chronic lymphocytic leukemia (CLL) was treated with 8 courses of R‐CHOP. Clinical remission was achieved, while B‐cell clonality remained. Allogeneic hematopoietic stem cell transplantation was performed with reduced intensity conditioning (fludarabine and 2‐Gy total body irradiation). However, autologous hematopoietic recovery occurred within a month after the transplant. Nevertheless, B‐cell clonality became undetectable at 14 days after transplant, which has been kept so for over 10 years with clinical remission. Cytogenetic analyses were repeatedly performed and demonstrated nonclonal chromosomal aberrations, although the patient did not develop any secondary malignancies. One possible explanation for the clinical course is a very short‐term allogeneic immune reaction helping eradication of residual CLL cells.
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