PDF(Pubmed)
Abstract：
T-cell prolymphocytic leukemia (T-PLL) is a rare aggressive disease with a poor prognosis. Allogeneic stem cell transplantation (allo-SCT) followed by alemtuzumab administration is the most promising treatment for T-PLL but is associated with a high risk of infections as alemtuzumab strongly suppresses cellular immunity, leading to high transplant-related mortality and unsatisfactory survival rates. In addition, for patients without human leukocyte antigen-matched donors, haploidentical stem cell transplantation (haplo-SCT) using post-transplant cyclophosphamide (PTCy) has been used because of the ready availability of donors and achievement of results comparable to those of transplantation with human leukocyte antigen-matched donors. However, there are no reports on the efficacy and safety, including infectious complications, of haplo-SCT with PTCy after alemtuzumab therapy in patients with. Here, we describe a 66-year-old Japanese male patient with T-PLL treated successfully with haplo-SCT after induction therapy of alemtuzumab for T-PLL. Approximately 3 months after the achievement of complete remission with alemtuzumab for T-PLL, haplo-SCT with reduced-intensity conditioning and PTCy was performed. Infectious complications were improved by early therapeutic interventions, and peripheral T cell counts gradually recovered. The patient was alive for more than 16 months after allo-SCT with no signs of relapse. Thus, haplo-SCT using PTCy should be considered as an option after alemtuzumab treatment for T-PLL.
摘要：
T细胞前淋巴细胞白血病（T-PLL）是一种罕见的侵袭性疾病，预后不良。同种异体干细胞移植（allo-SCT），随后给予阿仑珠单抗是T-PLL最有前途的治疗方法，但由于阿仑珠单抗强烈抑制细胞免疫，因此与感染的高风险相关。导致移植相关的高死亡率和不令人满意的存活率。此外,对于没有人类白细胞抗原匹配供体的患者，使用移植后环磷酰胺（PTCy）的单倍体干细胞移植（haplo-SCT）已被使用，因为供体易于获得，并且获得了与人类白细胞抗原匹配供体移植相当的结果。然而,没有关于疗效和安全性的报告，包括感染性并发症,阿仑珠单抗治疗后PTCy的haplo-SCT。这里,我们描述了1例66岁的日本男性T-PLL患者,在对T-PLL进行阿仑珠单抗诱导治疗后,成功应用了haplo-SCT治疗.阿仑珠单抗治疗T-PLL完全缓解后约3个月，进行了具有降低强度调节和PTCy的haplo-SCT。感染性并发症通过早期治疗干预得到改善，外周血T细胞计数逐渐恢复。患者在allo-SCT后存活超过16个月,没有复发的迹象。因此，在阿仑珠单抗治疗T-PLL后，应考虑使用PTCy进行haplo-SCT。
