[脐带血移植后成人T细胞白血病/淋巴瘤早期复发患者使用来那度胺可获得持久缓解]。

Masakazu Mori, Yuki Goto, Ryuichiro Hiyama, Ryo Ueda, Risa Hashida, Kyoko Itakusu, Kyosuke Saeki, Koichi Nakase, Yuichiro Nawa
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引用次数: 0

摘要

一名 62 岁的女性成人 T 细胞白血病/淋巴瘤(ATL)患者在接受脐带血移植(CBT)后病情首次完全缓解。然而,移植后第 74 天发现 ATL 复发,外周血中淋巴瘤细胞快速生长,可溶性白细胞介素-2 受体(sIL2R)水平升高。仅停止免疫抑制剂治疗并不能改善ATL的结果,但来那度胺治疗可使淋巴瘤细胞从外周血中消失,sIL2R水平恢复正常。观察到来那度胺相关不良反应为全血细胞减少,但淋巴细胞计数并未减少。根据Southern印迹分析和使用流式细胞术(HAS-Flow)进行的人类T细胞白血病病毒1(HTLV-1)感染细胞分析的结果,患者被判定为完全缓解。外周血的流式细胞术分析和X、Y染色体的FISH分析显示,来那度胺的治疗效果与供体外周自然杀伤细胞数量的增加有关。来那度胺治疗13个月后未发现ATL复发。我们的研究结果表明,来那度胺是治疗移植后复发ATL的有效选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Durable remission with lenalidomide in a patient with early relapse of adult T-cell leukemia/lymphoma after cord blood transplantation].

A 62-year-old woman with adult T-cell leukemia/lymphoma (ATL) received umbilical cord blood transplantation (CBT) in first complete remission. However, relapse of ATL was detected on day 74 post-transplantation, as evidenced by the rapid growth of lymphoma cells in peripheral blood and an increase in soluble interleukin-2 receptor (sIL2R) levels. Discontinuation of immunosuppressant therapy alone did not improve ATL findings, but treatment with lenalidomide caused lymphoma cells to disappear from the peripheral blood and sIL2R levels to return to normal. Pancytopenia was observed as a lenalidomide-associated adverse effect, but lymphocyte counts were not reduced. The patient was judged to be in complete remission based on results of Southern blot analysis and human T-cell leukemia virus 1 (HTLV-1)-infected cell analysis using flow cytometry (HAS-Flow). Flow cytometric analysis of peripheral blood and FISH analysis of X and Y chromosomes revealed that the therapeutic effect of lenalidomide was associated with an increase in the number of donor-derived peripheral natural killer cells. ATL relapse was not observed at 13 months into lenalidomide treatment. Our results suggest that lenalidomide is an effective option for the treatment of post-transplant relapsed ATL.

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