常规方案联合利妥昔单抗治疗单倍体相合HSCT后淋巴细胞增生性疾病三例

目的 观察含利妥昔单抗的方案治疗单倍体相合造血干细胞移植(HSCT)后淋巴细胞增生性疾病(PTLD)的疗效.方法 回顾性分析3例单倍体相合HSCT后PTLD患者的临床资料.3例分别于移植后57～164 d发生PTLD,临床表现为发热、浅表淋巴结肿大.经淋巴结组织病理检查确诊为PTLD,均为B淋巴细胞来源,EB病毒DNA阳性.采用减量或者停用免疫抑制剂,抗病毒治疗,应用利妥昔单抗(1例联合化疗)治疗.利妥昔单抗的剂量为375 mg/m2,每周1次,共用4次.结果 治疗后3例的淋巴结均明显缩小,患者的体温恢复正常,病情缓解.结论 PTLD是HSCT尤其是单倍体相合HSCT后的严重并发症,含利妥昔单抗的治疗方案对于PTLD的治疗效果较好.

Abstract：

Objective To evaluate the efficacy of rituximab-containing regimens on post-transplantation lymphoproliferative disorder (PTLD) following haploidentical hematopoietic stem cell transplantation (HSCT). Methods The clinical data of 3 cases of PTLD after haploidentical HSCT were analyzed retrospectively. Time to development of PTLD ranged from 57 to 164 days after HSCT.The main symptoms included fever, superficial lymph node enlargement. Epstein-Bart virus (EBV)-positive B-cell PTLD was diagnosed by biopsy of lymph node. Management of 3 patients consisted of withdraw of immunosuppressive treatment, anti-viral therapy, rituximab (375 rng/m2 , per week for four weeks) monotherapy or chemotherapy plus rituximab. Results All the patients had complete remission after treatment. Conclusion PTLD is a serious complication of HSCT especially haploidentical HSCT. Rituximab-containing regimens are potentially effective, well-tolerated with mild toxicity and improve the prognosis of PTLD following haploidentical HSCT.

Efficacy of rituximab-containing regimens on post-transplantation lymphoproliferative disorder following haploidentical hematopoietic stem cell transplantation: a report of 3 cases

Objective To evaluate the efficacy of rituximab-containing regimens on post-transplantation lymphoproliferative disorder (PTLD) following haploidentical hematopoietic stem cell transplantation (HSCT). Methods The clinical data of 3 cases of PTLD after haploidentical HSCT were analyzed retrospectively. Time to development of PTLD ranged from 57 to 164 days after HSCT.The main symptoms included fever, superficial lymph node enlargement. Epstein-Bart virus (EBV)-positive B-cell PTLD was diagnosed by biopsy of lymph node. Management of 3 patients consisted of withdraw of immunosuppressive treatment, anti-viral therapy, rituximab (375 rng/m2 , per week for four weeks) monotherapy or chemotherapy plus rituximab. Results All the patients had complete remission after treatment. Conclusion PTLD is a serious complication of HSCT especially haploidentical HSCT. Rituximab-containing regimens are potentially effective, well-tolerated with mild toxicity and improve the prognosis of PTLD following haploidentical HSCT.