Severe graft-versus-host disease post allogeneic hematopoietic stem cell transplantation due to loss of HLA heterozygosity in recipient lymphocytes after full graft rejection.

异基因造血干细胞移植后 ， 由于完全移植物排斥后受体淋巴细胞中 HLA 杂合性丧失 ， 导致严重的移植物抗宿主病。

• 发表时间: 2023 Aug
• 来源期刊: Cancer Innov
• DOI: 10.1002/cai2.72
• PMID: 38089744
• 文章类型: Case Reports
• 作者列表: Xue S,Miao L,Gong Z,Huang W,Zhang Y,Liu F,Wang J

关键词: chimerism; germ cell tumors; graft‐versus‐host disease; heterozygosity; stem cell transplantation

Abstract

Germ cell tumors complicated by hematological malignancy (HM) are a rare clinical phenomenon. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially effective therapy, but graft-versus-host disease (GVHD) is a life-threatening complication. We report a case of a 13-year-old female patient diagnosed with germ cell tumors followed by acute lymphoblastic leukemia. After chemotherapy, she received allo-HSCT and her chimerism rate decreased rapidly to near zero by 6 months without evidence of HM recurrence. However, she developed severe, multiorgan GVHD-like manifestations. DNA analysis revealed the pathogenesis of GVHD to be loss of HLA heterozygosity in recipient hematopoietic cells.

摘要

生殖细胞肿瘤并发血液系统恶性肿瘤（HM）是一种罕见的临床现象。异基因造血干细胞移植（allo-HSCT）是一种潜在的有效治疗方法，但是移植物抗宿主病(GVHD)是一种危及生命的并发症.我们报告了一例13岁的女性患者，被诊断为生殖细胞肿瘤，随后是急性淋巴细胞白血病。化疗后,她接受了allo-HSCT,且嵌合率在6个月时迅速下降至接近零,且无HM复发的证据.然而,她发展得很严重，多器官GVHD样表现。DNA分析显示GVHD的发病机制是受体造血细胞中HLA杂合性的丧失。