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。