Hematopoietic stem cell transplantation for Ph-like acute lymphoblastic leukemia and literature review

Chineae Journal of Organ Transplantation Pub Date : 2019-03-20 DOI:10.3760/CMA.J.ISSN.0254-1785.2019.03.005

Hai-ping Dai, Zheng Li, Jia Yin, Minghong Liu, Xiaming Zhu, Depei Wu

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Abstract

Objective To explore the efficacy of hematopoietic stem cell transplantation (HSCT) for 5 patients with Ph-like acute lymphoblastic leukemia (ALL). Methods Fluorescent in situ hybridization (FISH) was performed for detecting the rearrangement of susceptibility genes. Combined therapy of chemotherapy and ruxolitinib were applied, followed by HSCT. Those failing to achieve complete remission (CR) received an infusion of chimeric antigen T-cells (CAR-T), followed by HSCT once CR was achieved. Four patients accept allogenic HSCT while another auto HSCT. Results Three of them achieved CR after chemotherapy and ruxolitinib. The remaining 2 patients got CR after CAR-T. Four patients remained in CR after HSCT. Early relapse occurred in 1 patient after HSCT. Conclusions Combined therapy of chemotherapy, ruxolitinib and CAR-T are necessary for Ph-like ALL patients. HSCT after an initial CR improve patient prognosis. Key words: Heamatopoietic stem cell transplantation; Lymphoblastic leukemia; Acute

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造血干细胞移植治疗ph样急性淋巴细胞白血病并文献复习

目的探讨造血干细胞移植(HSCT)治疗ph样急性淋巴细胞白血病(ALL)的疗效。方法采用荧光原位杂交(FISH)技术检测易感基因重排。采用化疗联合鲁索利替尼治疗，术后行造血干细胞移植。未能达到完全缓解(CR)的患者接受嵌合抗原t细胞(CAR-T)输注，一旦达到完全缓解，则进行HSCT。4例患者接受同种异体移植，另1例接受自体移植。结果3例患者经化疗和鲁索利替尼治疗后达到CR。其余2例经CAR-T治疗后均获得CR。4例HSCT后仍处于CR期。1例HSCT术后早期复发。结论化疗、鲁索利替尼联合CAR-T治疗ph样ALL患者是必要的。初始CR后HSCT改善患者预后。关键词:造血干细胞移植;淋巴细胞白血病;急性

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Chineae Journal of Organ Transplantation

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