Abstract:
We report a case of therapy-related myelodysplastic syndrome (MDS), which developed 9 years after autologous peripheral blood stem cell transplantation (PBSCT) for peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). A 65-year-old male was diagnosed with PTCL-NOS. After 6 cycles of the CHOP (cyclophosphamide [CPA], doxorubicin, vincristine, and prednisone) regimen, he achieved a first complete response (CR). He relapsed 33 months later and received salvage chemotherapy, which consisted of the CHASE regimen (CPA, high-dose cytarabine, dexamethasone, and etoposide). During the recovery phase of the first cycle of CHASE, his peripheral blood stem cells (PBSCs) were harvested and frozen in 2 bags. After 2 courses of CHASE, he underwent autologous PBSCT, which involved the use of the LEED preconditioning regimen (melphalan, CPA, etoposide, and dexamethasone) and one of the frozen bags. This resulted in a second CR. At 39 months after PBSCT, he relapsed with a tumor in his right arm. After it was resected, he received eight cycles of brentuximab vedotin and 45 Gy of involved-field irradiation concurrently and achieved a third CR. Nine years after autologous PBSCT, he was diagnosed with MDS with excess blasts 2 (MDS-EB-2). His disease progressed to acute myeloid leukemia after 2 courses of azacitidine therapy. He successfully underwent a second autologous PBSCT involving the busulfan and melphalan preconditioning regimen and the other frozen bag, which had been stored for 9 years. He has been in complete cytogenetic remission for 1 year since the second autologous PBSCT.
摘要:
我们报告一例治疗相关的骨髓增生异常综合征(MDS),自体外周血干细胞移植(PBSCT)治疗外周T细胞淋巴瘤9年后,没有另外规定(PTCL-NOS)。一名65岁男性被诊断患有PTCL-NOS。经过6个周期的CHOP(环磷酰胺[CPA],阿霉素,长春新碱,和泼尼松)方案,他获得了第一个完整响应(CR)。他33个月后复发,接受了挽救性化疗,其中包括CHASE方案(CPA,大剂量阿糖胞苷,地塞米松,和依托泊苷)。在CHASE第一个周期的恢复阶段,收集他的外周血干细胞(PBSCs)并冷冻在2个袋中.经过2个疗程的CHASE,他接受了自体PBSCT,其中涉及使用LEED预处理方案(美法仑,CPA,依托泊苷,和地塞米松)和一个冷冻袋。这导致了第二个CR。PBSCT后39个月,他的右臂有肿瘤复发了.切除后,他同时接受了8个周期的Brentuximabvedotin和45Gy的参与场照射,并获得了第三个CR。自体PBSCT后九年,他被诊断为MDS伴过度母细胞2(MDS-EB-2)。经过2个疗程的阿扎胞苷治疗后,他的疾病进展为急性髓细胞性白血病。他成功接受了第二次自体PBSCT,包括白消安和美法仑预处理方案和另一个冷冻袋,已经储存了9年。自第二次自体PBSCT以来,他已经完全细胞遗传学缓解了1年。