Relapse after allogeneic hematopoietic stem cell transplantation(allo-HSCT) remains a main question on treatment failure. Current strategies for management that usually include salvage chemotherapy, donor lymphocyti...Relapse after allogeneic hematopoietic stem cell transplantation(allo-HSCT) remains a main question on treatment failure. Current strategies for management that usually include salvage chemotherapy, donor lymphocytic infusion and second transplantation. Our study assessed the efficacy of decitabine(DAC) for treating patients with acute lymphoblastic leukemia(ALL) who relapsed after allogeneic hematopoietic stem cell transplantation(allo-HSCT). We retrospectively analyzed the outcomes of 12 patients with relapsed ALL after allo-HSCT who received DAC therapy. Nine patients received DAC combined with chemotherapy and donor stem cell infusion, and 3 patients received single-agent DAC. Ten of the 12 patients achieved complete remission(CR), 1 achieved a partial remission(PR), and 1 had no response(NR) after treatment at the latest follow-up(LFU), the median survival was 11.2 months(range, 3.8–34, 7 months). The 1-and 2-year overall survival(OS) rates were 50%(6/12) and 25%(3/12), respectively. Five patients were still alive; 4 had maintained CR and 1 was alive with disease. Patients with Philadelphia chromosome-positive ALL had higher survival rate than patients with Philadelphia chromosome-negative ALL(57.1% vs. 20%). No aggravated flares of graft-versus-host disease(GVHD) were observed during DAC treatment. Therefore, DAC may be a promising therapeutic agent for ALL recurrence after allo-HSCT.展开更多
目的探讨脐带间充质干细胞(UCMSCs)治疗儿童异基因造血干细胞移植(allo-HSCT)后激素难治性急性移植物抗宿主病(SR-aGVHD)的疗效、安全性和生存情况。方法回顾性分析2014年2月—2018年12月在本院血液科行allo-HSCT术后发生SR-aGVHD的患...目的探讨脐带间充质干细胞(UCMSCs)治疗儿童异基因造血干细胞移植(allo-HSCT)后激素难治性急性移植物抗宿主病(SR-aGVHD)的疗效、安全性和生存情况。方法回顾性分析2014年2月—2018年12月在本院血液科行allo-HSCT术后发生SR-aGVHD的患儿临床资料59例,根据治疗过程中是否接受UCMSCs治疗分为UCMSCs组(n=33)和常规组(n=26)。结果UCMSCs组中UCMSCs静脉输注平均细胞数为1.70(0.43-5.78)×106/kg,平均次数为2(1—5)次,均未见输注不良反应。与常规组相比,UCMSCs组在治疗SR-aGVHD的改善中位时间上更短(12 d vs 18 d,P<0.05);2组之间在治疗SR-aGVHD的治愈时间,皮肤、肝脏、胃肠道疗效的总体反应率,单器官和多器官受累的SR-aGVHD疗效的完全缓解率差异均无统计学意义(P>0.05)。UCMSCs组广泛型cGVHD发生率、巨细胞病毒(CMV)感染率低于常规组(P>0.05),EBV感染率及复发率高于常规组(P>0.05)。结合生存曲线,UCMSCs和常规组2组患儿累及生存率无明显差异。结论UCMSCs治疗儿童移植后SR-aGVHD有一定疗效且安全,改善时间更快,对是否会预防CMV感染、广泛型cGVHD的发生及增加移植后EB病毒感染率、复发率和能否改善移植后长期生存需进一步扩大样本研究。展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81300412 and No.81470333)
文摘Relapse after allogeneic hematopoietic stem cell transplantation(allo-HSCT) remains a main question on treatment failure. Current strategies for management that usually include salvage chemotherapy, donor lymphocytic infusion and second transplantation. Our study assessed the efficacy of decitabine(DAC) for treating patients with acute lymphoblastic leukemia(ALL) who relapsed after allogeneic hematopoietic stem cell transplantation(allo-HSCT). We retrospectively analyzed the outcomes of 12 patients with relapsed ALL after allo-HSCT who received DAC therapy. Nine patients received DAC combined with chemotherapy and donor stem cell infusion, and 3 patients received single-agent DAC. Ten of the 12 patients achieved complete remission(CR), 1 achieved a partial remission(PR), and 1 had no response(NR) after treatment at the latest follow-up(LFU), the median survival was 11.2 months(range, 3.8–34, 7 months). The 1-and 2-year overall survival(OS) rates were 50%(6/12) and 25%(3/12), respectively. Five patients were still alive; 4 had maintained CR and 1 was alive with disease. Patients with Philadelphia chromosome-positive ALL had higher survival rate than patients with Philadelphia chromosome-negative ALL(57.1% vs. 20%). No aggravated flares of graft-versus-host disease(GVHD) were observed during DAC treatment. Therefore, DAC may be a promising therapeutic agent for ALL recurrence after allo-HSCT.
文摘侵袭性真菌病(invasive fungal disease,IFD)是异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,allo-HSCT)术后常见并发症,最常见致病菌为念珠菌和曲霉菌。近些年来,中枢神经系统真菌感染(fungal infections of the central nervous system,FIs-CNS)发病率逐渐增加,治疗难度大.
文摘目的探讨脐带间充质干细胞(UCMSCs)治疗儿童异基因造血干细胞移植(allo-HSCT)后激素难治性急性移植物抗宿主病(SR-aGVHD)的疗效、安全性和生存情况。方法回顾性分析2014年2月—2018年12月在本院血液科行allo-HSCT术后发生SR-aGVHD的患儿临床资料59例,根据治疗过程中是否接受UCMSCs治疗分为UCMSCs组(n=33)和常规组(n=26)。结果UCMSCs组中UCMSCs静脉输注平均细胞数为1.70(0.43-5.78)×106/kg,平均次数为2(1—5)次,均未见输注不良反应。与常规组相比,UCMSCs组在治疗SR-aGVHD的改善中位时间上更短(12 d vs 18 d,P<0.05);2组之间在治疗SR-aGVHD的治愈时间,皮肤、肝脏、胃肠道疗效的总体反应率,单器官和多器官受累的SR-aGVHD疗效的完全缓解率差异均无统计学意义(P>0.05)。UCMSCs组广泛型cGVHD发生率、巨细胞病毒(CMV)感染率低于常规组(P>0.05),EBV感染率及复发率高于常规组(P>0.05)。结合生存曲线,UCMSCs和常规组2组患儿累及生存率无明显差异。结论UCMSCs治疗儿童移植后SR-aGVHD有一定疗效且安全,改善时间更快,对是否会预防CMV感染、广泛型cGVHD的发生及增加移植后EB病毒感染率、复发率和能否改善移植后长期生存需进一步扩大样本研究。