Ph样急性淋巴细胞白血病9例临床分析并预后评估

刘霜竹; 杨海飞; 吴德沛

doi:10.13201/j.issn.1004-2806.2020.11.008

Ph样急性淋巴细胞白血病9例临床分析并预后评估

- 苏州大学附属第一医院江苏省血液研究所苏州大学造血干细胞移植研究所血液学协同创新中心卫生部血栓与止血重点实验室江苏省干细胞与生物医用材料重点实验室(省部共建国家重点实验室培养基地)(江苏苏州, 215006)
基金项目:
国家自然科学基金(No:81730003)

详细信息

通讯作者: 吴德沛,E-mail:wudepei@suda.edu.cn

中图分类号: R733.71

收稿日期: 2020-08-16

Ph-like acute lymphocytic leukemia:Clinical study of 9 cases and prognostic evaluation

- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University;Institute of Blood and Marrow Transplantation;Collaborative Innovation Center of Hematology, Soochow University;Key Laboratory of Thrombosis and Hemostasis of Ministry of Health;Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, 215006, China

More Information

Corresponding author: WU De-pei, E-mail: wudepei@suda.edu.cn

Received Date: 16 August 2020

摘要

摘要: 目的:探讨Ph样急性淋巴细胞白血病（Ph-like ALL）的发病特点、治疗及预后。方法:采用荧光原位杂交检测9例Ph-like ALL患者常见基因重排,给予化疗联合芦可替尼、酪氨酸激酶抑制剂诱导治疗,未缓解的患者接受嵌合抗原受体T（CAR-T）细胞治疗,在获得完全缓解后行造血干细胞移植。其中6例受者接受异基因造血干细胞移植,1例受者接受自体造血干细胞移植。结果:9例患者中有7例进行了造血干细胞移植,其中6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。剩余2例未进行移植,其中1例在CAR-T治疗后本病复发死亡,另1例因重度感染死亡。结论:联合传统化疗、芦可替尼、酪氨酸激酶抑制剂和CAR-T等综合治疗手段使患者尽快达完全缓解,并序贯造血干细胞移植,有望改善此类患者的预后,未进行造血干细胞移植的此类患者预后较差。
- Ph样急性淋巴细胞白血病 /
- 造血干细胞移植 /
- 嵌合抗原受体T细胞
Abstract: Objective:To explore the clinical characteristics,treatment and prognosis of patients with Ph-like acute lymphocytic leukemia.Method:Fluorescent insitu hybridization was used to detect the rearrangement of susceptibility genes in 9 patients with Ph-like acute lymphocytic leukemia.Patients were treated with chemotherapy combined with ruxolitinib and tyrosine kinase inhibitor induction therapy.Patients without remission received chimeric antigen receptor T（CAR-T）cell therapy.After complete remission,hematopoietic stem cell transplantation was performed.Six patients received allogeneic hematopoietic stem cell transplantation and 1 patient received autologous hematopoietic stem cell transplantation.Result:Among the 9 patients,7 cases received hematopoietic stem cell transplantation,of which 6 cases achieved continuous complete remission and 1 case had early recurrence after transplantation.The remaining 2 cases did not receive transplantation,with one case dying from recurrence after CAR-T treatment and the other dying from severe infection.Conclusion:Combined therapy of chemotherapy,ruxolitinib,tyrosine kinase inhibitor and CAR-T are necessary for Ph-1 ike acute lymphocytic leukemia patients.Hematopoietic stem cell transplantation after an initial complete remission can improve the prognosis of patients.The prognosis of these patients without hematopoietic stem cell transplantation is poor.
- Ph-like acute lymphocytic leukemia /
- hematopoietic stem cell transplantation /
- CAR-T

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