异基因造血干细胞移植前后应用地西他滨治疗骨髓增生异常综合征转化的急性髓系白血病——1例治疗经验及文献复习

许国发; 陈婷; 蔺诗佳; 刘焕凤; 邓天霞; 高蕾; 刘耀; 张诚; 高力; 张曦; 孔佩艳

doi:10.13201/j.issn.1004-2806.2018.01.013

异基因造血干细胞移植前后应用地西他滨治疗骨髓增生异常综合征转化的急性髓系白血病——1例治疗经验及文献复习

- 1. 重庆市涪陵中心医院血液科(重庆, 400800);
- 2. 陆军军医大学第二附属医院新桥医院血液科

详细信息

通讯作者: 孔佩艳,E-mail:peiyankong@163.com

中图分类号: R733.7

收稿日期: 2017-09-26

The treatment of decitabine in acute myeloid leukemia transformed by myelodysplastic syndrome before and after allogeneic hematopoietic stem cell transplantation:a case report and literature review

More Information

Corresponding author: KONG Peiyan, E-mail: peiyankong@163.com

Received Date: 26 September 2017

摘要

- FLT3-ITD阳性 /
- 急性髓系白血病 /
- 骨髓增生异常综合征 /
- 地西他滨 /
- 异基因造血干细胞移植 /
- 无关供者
Abstract: Acute myeloid leukemia (AML) transformed by myelodysplastic syndrome (MDS) has low complete remission,high risk of relapse,short survival time and poor prognosis.If the patients also with FLT3-ITD positive,the outcome will be worse,and the possibility of survival is very low,even after allogeneic hematopoietic stem cell transplantation (Allo-HSCT).In this paper a 44 year old female patient with FLT3-ITD⁺ AML-M₅,transformed by MDS treated in our department were reported.The patient received chemotherapy with decitabine before and unrelated donor Allo-HSCT,and maintenance therapy of small dose of decitabine after HSCT.The early relapse after transplantation was successfully controlled,and the life of the patient had been over 2 years.
- FLT3-ITD positive /
- acute myeloid leukemia /
- myelodysplastic syndrome /
- decitabine /
- allogeneic hematopoietic stem cell transplantation /
- unrelated donor

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参考文献(18)

[1]	Hambin T.The treatment of acute myeloid leukemia preceded by the myelodysplastic syndrome[J].Leuk Res, 1992, 16:101-108.
[2]	Duval M, Klein JP, He W, et al.Hematopoietic stemcell transplantation for acute leukemia in relapse or primary induction failure[J].J Clin Oncol, 2010, 28:3730-3738.
[3]	许倩, 孙爱宁, 陈苏宁, 等.多疗程地西他滨治疗骨髓增生异常综合征及急性髓系白血病患者的回顾性分析[J].临床血液学杂志, 2017, 30 (3):198-201.
[4]	Zhang C, Chen XH, Liu J, et al.Decitabine as a conditioning regimen in haploidentical stem cell transplantation for refractory acute myeloid leukaemia[J].JClin Pharm Ther, 2015, 40:336-338.
[5]	Jung HA, Maeng CH, Kim M, et al.Platelet response during the second cycle of decitabine treatment predicts response and survival for myelodysplastic syndrome patients[J].Oncotarget, 2015, 6:16653-16662.
[6]	van der Helm LH, Alhan C, Wijermans PW, et al.Platelet doubling after the first azacitidine cycle is a promising predictor for response in myelodysplastic syndromes (MDS), chronic myelomonocytic leukaemia (CMML) and acute myeloid leukaemia (AML) patients in the Dutch azacitidine compassionate named patient programme[J].Br J Haematol, 2011, 155:599-606.
[7]	Itzykson R, Kosmider O, Cluzeau T, et al.Impact of TET2mutations on response rate to azacitidine in myelodysplastic syndromes and low blast count acute myeloid leukemias[J].Leukemia, 2011, 25:1147-1152.
[8]	Ettou S, Audureau E, Humbrecht C, et al.Fas expression at diagnosis as a biomarker of azacitidine activity in high-risk MDS and secondary AML[J].Leukemia, 2012, 26:2297-2299.
[9]	Uy GL, Duncavage EJ, Chang GS, et al.Dynamic changes in the clonal structure of MDS and AML in response to epigenetic therapy[J].Leukemia, 2017, 31:872-881.
[10]	Choi J, Ritchey J, Prior JL, et al.In vivo administration of hypomethylating agents mitigate graft-versus-host disease without sacrificing graft-versus-leukemia[J].Blood, 2010, 116:129-139.
[11]	Goodyear OC, Dennis M, Jilani NY, et al.Azacitidine augments expansion of regulatory T cells after allogeneic stem cell transplantation in patients with acute myeloid leukemia (AML)[J].Blood, 2012, 119:3361-3369.
[12]	Platzbecker U, Wermke M, Radke J, et al.Minimal residual disease (MRD) bases preemptive 5-azacytidine treatment can prevent or delay imminent relapse in patients with high risk MDS or AML after allogenic HSCT.Results of the"RELAZA"trial[C].ASH Annual Meeting Abstract, 2010, 116:679.
[13]	Ganguly S, Amin M, Divine C, et al.Decitabine in patients with relapsed acute myeloid leukemia (AML) after allogeneic stem cell transplantation (Allo-SCT)[J].Ann Hematol, 2013, 92:549-550.
[14]	Han S, Kim YJ, Lee J, et al.Model-based adaptive phase I trial design of post-transplant decitabine maintenance in myelodysplastic syndrome[J].J Hematol Oncol, 2015, 8:118.
[15]	Pusic I, Choi J, Fiala MA, et al.Maintenance therapy with decitabine after allogeneic stem cell transplantation for acute myelogenous leukemia and myelodysplastic syndrome[J].Biol Blood Marrow Transplant, 2015, 21:1761-1769.
[16]	Antar A, Otrock ZK, Kharfan-Dabaja M, et al.Azacitidine in the treatment of extramedullary relapse of AML after allogeneic hematopoietic cell transplantation[J].Bone Marrow Transplant, 2013, 48:994-995.
[17]	Schroeder T, Rautenberg C, Haas R, et al.Hypomethylating agents after allogeneic blood stem cell transplantation[J].Stem Cell Investig, 2016, 3:84.
[18]	Schmid C, Labopin M, Nagler A, et al.Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation[J].Blood, 2012, 119:1599-1606.