Autologous stem cell transplantation

自体干细胞移植
  • 文章类型: Journal Article
    目的:非典型畸胎瘤样横纹肌样瘤(ATRT)是一种罕见且高度侵袭性的原发性中枢神经系统肿瘤,主要在儿童中观察到。在儿科ATRT中使用自体干细胞移植(ASCT)已显示出希望;然而,其在成人ATRT中的效用尚不清楚。患者和方法:本研究介绍了ATRT成年患者在ASCT后缓解的情况,并回顾了ATRT成人中ASCT的文献。确定了4例接受ASCT的成人ATRT,总结了相关数据。结果:所有5例患者的生存时间均超过历史平均生存率,其中4人在最后一次随访时没有疾病的临床或影像学证据.结论:基于有限的数据,ASCT可能在成人ATRT治疗中发挥作用.
    [方框:见正文]。
    Aim: Atypical teratoid rhabdoid tumor (ATRT) is a rare and highly aggressive primary CNS neoplasm, predominantly observed in children. The use of autologous stem cell transplantation (ASCT) in pediatric ATRT has shown promise; however, its utility in adult ATRT remains unclear. Patients & methods: This study presents the case of an adult patient with ATRT who is in remission after ASCT and reviews the literature on ASCT in adults with ATRT. Four cases of ATRT in adults who underwent ASCT were identified, with pertinent data summarized. Results: All five patients survived longer than the historical average survival rate, four of whom had no clinical or radiographic evidence of disease at the final follow-up. Conclusion: Based on limited data, there may be a role for ASCT in the treatment of adults with ATRT.
    [Box: see text].
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:鉴于多发性骨髓瘤(MM)幸存者的生存率提高,我们试图评估他们与普通人群相比继发恶性肿瘤的风险.
    方法:这项全国性的基于人群的病例对照队列研究利用了韩国国家健康保险服务(KNHIS)数据库,其中包含2009年至2020年的数据。我们分析了病例队列中诊断为MM的7348例患者。我们从没有MM的普通人群中选择了29,351个人的对照组,采用1:4倾向得分匹配方法。匹配标准包括年龄、性别,和合并症,以确保平衡和可靠的比较。
    结果:病例队列中任何继发性恶性肿瘤的累积发生率均显着高于对照组(危险比[HR]1.576,95%置信区间[CI],[1.381-1.798]).病例队列中恶性血液病风险明显较高(HR8.026,95%CI,[5.402-11.924]),尤其是治疗相关性髓系肿瘤(t-MN)(HR12.063,95%CI,[6.839-21.278])。非血液系统恶性肿瘤的发生率没有显着差异。在亚组分析中,符合移植条件的MM患者的任何继发性恶性肿瘤发生率(HR1.104,95%CI,[1.003-1.214])明显高于不符合移植条件的患者.与来那度胺时代相比,来那度胺可用时代的MM患者继发性恶性肿瘤的发生率并未显着增加。
    结论:虽然血液系统恶性肿瘤,特别是t-MN,与一般人群相比,MM患者显著升高,非血液系统恶性肿瘤似乎没有显著升高.
    BACKGROUND: In light of improved survival rates among multiple myeloma (MM) survivors, we sought to assess their risk of secondary malignancies compared to the general population.
    METHODS: This nationwide population-based case-control cohort study utilized the Korea National Health Insurance Service (KNHIS) database incorporating data from 2009 to 2020. We analyzed a total of 7348 patients diagnosed with MM in the case cohort. We selected a control group of 29,351 individuals from the general population without MM, employing a 1:4 propensity score matching approach. Matching criteria included age, sex, and comorbidities to ensure a balanced and reliable comparison.
    RESULTS: The cumulative incidence of any secondary malignancy was significantly higher in the case cohort than the control cohort (Hazard ratio [HR] 1.576, 95% confidence interval [CI], [1.381-1.798]). Hematologic malignancy risk was notably higher in the case cohort (HR 8.026, 95% CI, [5.402-11.924]), especially therapy-related myeloid neoplasms (t-MN) (HR 12.063, 95% CI, [6.839-21.278]). No significant difference was shown in nonhematologic malignancy incidence. In subgroup analysis, transplant-eligible MM patients had a significantly higher incidence of any secondary malignancy (HR 1.104, 95% CI, [1.003-1.214]) than transplant-ineligible patients. The incidence of secondary malignancy in MM patients in the lenalidomide-available era was not significantly increased compared to the prelenalidomide era.
    CONCLUSIONS: While hematologic malignancies, particularly t-MN, are significantly elevated in MM patients compared to general population, nonhematologic malignancies do not appear to be significantly elevated.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    此病例报告描述了一例罕见且有趣的多发性骨髓瘤患者,并发轻链(LC)铸型肾病和局灶性淀粉样变性。患者出现急性肾损伤,贫血和骨损伤。骨髓活检证实了诊断,血清和尿液电泳和肾活检。患者接受了伊沙唑米治疗,泊马度胺和地塞米松联合化疗,其次是自体干细胞移植。患者达到临床缓解,稳定的肾功能和改善的血清lambda游离LC水平。这个案例突出了这种疾病的诊断和治疗方面的挑战和进步。
    This case report describes a rare and interesting case of a patient with multiple myeloma complicated with light chain (LC) cast nephropathy and focal amyloidosis. The patient presented with acute kidney injury, anaemia and bone lesions. The diagnosis was confirmed by bone marrow biopsy, serum and urine electrophoresis and kidney biopsy. The patient was treated with isazomil, pomalidomide and dexamethasone combination chemotherapy, followed by autologous stem cell transplantation. The patient achieved clinical remission, stable renal function and improved serum lambda free LC levels. This case highlights the challenges and advances in the diagnosis and treatment of this condition.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    系统性红斑狼疮(SLE)患者患癌症的风险更高,特别是血液恶性肿瘤,如淋巴瘤和白血病。然而,关于SLE诊断后评估癌症发病率的现有研究有限.此外,SLE可以在癌症后诊断,尽管很少报道儿童中的此类病例。
    我们介绍了一个2.6岁的男孩,他因发烧和腹痛来到我们的研究所。他的体格检查发现脐带周围有肿块,病理诊断为Burkitt淋巴瘤.进行自体干细胞移植以巩固化疗的效果并降低癌症复发的风险。五年后他被诊断出患有SLE,在出现皮疹发烧之后,自身抗体阳性,补体减少,和肾脏受累。在最后的后续行动中,患者仍然存活,未出现Burkitt淋巴瘤复发或SLE疾病活动性.
    尽管淋巴瘤患儿发生SLE的频率较低,癌症和SLE可能由涉及B细胞克隆和增殖的共同机制诱导。因此,在患者随访期间,血液学家和风湿病学家应了解这两种情况的发生。
    UNASSIGNED: Patients with systemic lupus erythematosus (SLE) are at a higher risk of developing cancer, particularly hematological malignancies such as lymphoma and leukemia. However, existing studies on this topic that assess cancer incidence following SLE diagnosis are limited. In addition, SLE can be diagnosed after cancer, although such cases in children have been rarely reported.
    UNASSIGNED: We present the case of a 2.6-year-old boy who presented to our institute with fever and abdominal pain. His physical examination revealed a periumbilical mass, which was pathologically diagnosed as Burkitt\'s lymphoma. Autologous stem cell transplantation was performed to consolidate the effect of chemotherapy and reduce the risk of cancer relapse. He was diagnosed with SLE 5 years later, following the presentation of a fever with rash, positive autoantibodies, decreased complement, and kidney involvement. At the final follow-up, the patient was still alive and showed no recurrence of Burkitt\'s lymphoma or disease activity of SLE.
    UNASSIGNED: Despite the low frequency of SLE in children with lymphoma, cancer and SLE may be induced by a common mechanism involving B-cell cloning and proliferation. Therefore, hematologists and rheumatologists should be aware of the occurrence of these two conditions during patient follow-up.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    间变性淋巴瘤激酶阳性的间变性大细胞淋巴瘤(ALK+ALCL)是一种罕见的,成熟T细胞非霍奇金淋巴瘤.一线化疗后复发或难治性ALCL患者的预后极差。NCCN指南建议对r/rALCL进行有或无ASCT巩固的强化化疗,然而,这不是所有ALK+ALCL的有效治疗方法。
    这里,我们报告1例复发/难治性ALK+ALCL患者接受克唑替尼和布伦妥昔单抗vedotin桥接治疗,其次是自体干细胞移植和序贯抗CD30CART细胞治疗。
    患者获得了完全缓解和几个月的长期无病生存期,并继续随访。这种情况下的联合治疗模式可以为复发/难治性ALK+ALCL的治疗提供指导。需要进一步的前瞻性试验来确认其有效性.
    Anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK+ ALCL) is a rare, mature T-cell non-Hodgkin lymphoma. The prognosis of patients with relapsed or refractory ALCL following first-line chemotherapy is extremely poor. NCCN guidelines recommend intensified chemotherapy with or without ASCT consolidation for r/r ALCL, however, this is not an effective treatment for all ALK+ALCL.
    Herein, we report a patient with relapsed/refractory ALK+ ALCL who received crizotinib and brentuximab vedotin as bridging therapy, followed by autologous stem cell transplantation and sequential anti-CD30 CAR T cell therapy.
    The patient achieved complete remission and long-term disease-free survival of months and continues to be followed up. The combination therapy model in this case may provide guidance for the management of relapsed/refractory ALK+ ALCL, and further prospective trials are needed to confirm its effectiveness.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    尽管预后有显著改善,一部分原发性中枢神经系统淋巴瘤(PCNSL)患者的复发风险仍然很高.复发和难治性(R/R)PCNSL的治疗仍然是主要的临床挑战。在这里,我们介绍了一名24岁的PCNSL患者,在最初诊断后4年复发,随后对大剂量甲氨蝶呤(HD-MTX)难治性,替莫唑胺,全脑放射治疗(WBRT),伊布替尼,还有来那度胺.她接受了具有抗程序性细胞死亡蛋白1(PD-1)抗体的Thiotepa,并获得了部分缓解,然后进行了基于Thiotepa的自体干细胞移植(ASCT)。在R/RPCNSL的这种情况下,以3个月的间隔使用thiotepa和抗PD-1进行移植后维持可导致持久的完全反应(CR)。我们的报告强调了Thiotepa在R/RPCNSL患者治疗中的重要作用。
    Despite significant improvements in prognosis, a subset of patients with primary central nervous system lymphoma (PCNSL) remains at high risk for relapse. The treatment of relapsed and refractory (R/R) PCNSL remains a major clinical challenge. Herein, we present a 24-year-old patient with PCNSL who relapsed 4 years after initial diagnosis and subsequently became refractory to high-dose methotrexate (HD-MTX), temozolomide, whole brain radiation therapy (WBRT), ibrutinib, and lenalidomide. She received thiotepa with anti-programmed cell death protein 1 (PD-1) antibody and achieved partial remission and then underwent autologous stem cell transplantation (ASCT) with thiotepa-based conditioning. Post-transplant maintenance with thiotepa and anti-PD-1 at 3-month intervals resulted in a durable complete response (CR) in this case of R/R PCNSL. Our report highlights the important role of thiotepa in the treatment of patients with R/R PCNSL.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    背景:单形上皮肠T细胞淋巴瘤(MEITL)是一种罕见的外周T细胞淋巴瘤。临床表现为腹泻,腹痛,穿孔和腹部肿块。
    方法:我们介绍了一名诊断为MEITL的52岁女性患者。多线化疗后观察到疾病进一步进展。最终,病人死于严重感染。
    结论:MEITL是一种罕见的肠道原发性T细胞淋巴瘤,具有侵袭行为,严重危及生命的并发症的高风险,预后不良.
    BACKGROUND: Monomorphic epithelial intestinal T-cell lymphoma (MEITL) is a rare type of peripheral T-cell lymphoma. The clinical manifestations are diarrhea, abdominal pain, perforation and an abdominal mass.
    METHODS: We present a 52-year-old female patient who was diagnosed with MEITL. Further disease progression was observed after multiline chemotherapy. Eventually, the patient died of a severe infection.
    CONCLUSIONS: MEITL is a rare intestinal primary T-cell lymphoma with aggressive behavior, a high risk of severe life-threatening complications, and a poor prognosis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:Clarkson病是一种非常罕见的疾病,其特征是急性发作的全身性水肿和与副蛋白血症相关的严重低血压。其经典治疗依赖于甲基黄嘌呤与特布他林的组合。尽管这种预防性治疗降低了死亡率,复发频繁。80%的Clarkson病患者存在未知意义的单克隆丙种球蛋白病(MGUS)。进展为多发性骨髓瘤的风险为每年1%。
    方法:这里,我们介绍了一名49岁的女性,她遭受了多次此类发作,需要在重症监护室接受治疗。特布他林和茶碱治疗无效。在第一次急性发作8年后,她被诊断出患有多发性骨髓瘤(MM)。开始用硼替佐米和地塞米松治疗骨髓炎,其次是自体造血移植,从那以后没有进一步的急性发作。
    结论:我们的案例是,根据我们的知识,独特的原因是根除MM后毛细血管渗漏的急性发作完全消失。我们的病例报告也是第一个支持在这种情况下使用硼替佐米和地塞米松的病例报告。此外,自体外周血祖细胞移植巩固了MM的严格完全缓解,实现了MM和Clarkson病的非常长的无进展生存期(>11年)。
    BACKGROUND: Clarkson\'s disease is a very rare entity characterised by acute episodes of systemic oedema and severe hypotension associated with paraproteinaemia. Its classical treatment relies on methylxanthine combined with terbutaline. Although this prophylactic therapy reduces the mortality rate, relapses are frequent. Eighty percent of patients with Clarkson\'s disease present with monoclonal gammopathy of unknown significance (MGUS). The risk of progression to multiple myeloma is 1% per year.
    METHODS: Here, we present a 49-year-old woman who suffered multiple such episodes requiring treatment in the intensive care unit. Treatment with terbutaline and theophylline was ineffective. She was diagnosed with multiple myeloma (MM) 8 years after the first of these acute episodes. Antimyeloma treatment with bortezomib and dexamethasone was started, followed by autologous haemopoietic transplantation, with no further acute episodes since then.
    CONCLUSIONS: Our case is, to our knowledge, unique because eradication of MM was followed by complete disappearance of acute episodes of capillary leakage. Our case report is also the first to support the use of bortezomib and dexamethasone in this setting. Furthermore, autologous peripheral blood progenitor cell transplantation consolidated the MM stringent complete remission achieving a very long progression-free survival (> 11 years) of both MM and Clarkson\'s disease.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    滤泡性淋巴瘤(FL),常见的惰性B细胞淋巴瘤,有可能转变为侵袭性淋巴瘤,如弥漫性大B细胞淋巴瘤(DLBCL)。转化滤泡性淋巴瘤(tFL)患者的预后较差,尤其是化疗后转化淋巴瘤患者和24个月内进展的患者(POD24)。嵌合抗原受体(CAR)T细胞疗法联合自体干细胞移植(ASCT)具有良好的抗肿瘤疗效。
    这里,我们描述了一名39岁的男性患者,最初被诊断为FL,转化为具有POD24,CD20阴性的DLBCL,TP53突变,经过3行治疗后,肿块很大,所有这些都是不良预后因素.我们应用了一种组合方法:ASCT后的CD19CART细胞输注。伊布替尼持续服用以提高疗效,DHAP作为挽救性化疗,ICE作为桥接方案施用。患者在-7~-1天接受BEAM预处理,在第01~02天总共输注3.8×106/kgCD34+干细胞,总共108个CART细胞(relmacabtageneautoleucel,relma-cel,JWCAR029)在第03天输注。患者出现2级细胞因子释放综合征(CRS),根据机构标准表现为发热和低血压。CAR-T细胞输注后无免疫效应细胞相关神经毒性综合征(ICANS)。最后,患者在+1个月时达到CMR,一直保持没有任何其他不利影响。
    这个案例突出了CD19CART细胞疗法在ASCT后对R/RtFL的惊人功效,从而为未来的治疗策略提供新的见解。
    Follicular lymphoma (FL), a common indolent B-cell lymphoma, has the potential to transform into an aggressive lymphoma, such as diffuse large B-cell lymphoma (DLBCL). The outcome of patients with transformed follicular lymphoma (tFL) is poor, especially in patients with transformed lymphoma after chemotherapy and patients with progression within 24 months (POD24). Chimeric antigen receptor (CAR) T-cell therapy combined with autologous stem cell transplantation (ASCT) has promising antitumor efficacy.
    Here, we described a 39-year-old male patient who was initially diagnosed with FL that transformed into DLBCL with POD24, CD20 negativity, TP53 mutation, and a bulky mass after 3 lines of therapy, all of which were adverse prognostic factors. We applied a combination approach: CD19 CAR T-cell infusion following ASCT. Ibrutinib was administered continuously to enhance efficacy, DHAP was administered as a salvage chemotherapy, and ICE was administered as a bridging regimen. The patient underwent BEAM conditioning on days -7~ -1, a total of 3.8 × 106/kg CD34+ stem cells were infused on days 01~02, and a total of 108 CAR T cells (relmacabtagene autoleucel, relma-cel, JWCAR029) were infused on day 03. The patient experienced grade 2 cytokine release syndrome (CRS), manifesting as fever and hypotension according to institutional standards. There was no immune effector cell-associated neurotoxicity syndrome (ICANS) after CAR T-cell infusion. Finally, the patient achieved CMR at +1 month, which has been maintained without any other adverse effects.
    This case highlights the amazing efficacy of CD19 CAR T-cell therapy following ASCT for R/R tFL, thus providing new insight on therapeutic strategies for the future.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    多发性神经病,器官肿大,内分泌病,单克隆浆细胞疾病,和皮肤变化(POEMS)综合征是一种罕见的多系统副肿瘤疾病,由潜在的浆细胞发育不良引起。其诊断基于两个强制性标准以及至少一个主要标准和一个次要标准的存在。我们报告了一例52岁的女性患者,该患者主诉性突发症,盗汗,鳞状皮肤,颈部左侧肿胀。她是一个已知的甲状腺功能减退症病例,抗磷脂综合征,脑静脉血栓形成,还有其他合并症.她还表现出四肢无力和感觉异常以及手部肌肉萎缩。进行了所有必要的检查和调查,患者最终被诊断为POEMS综合征。她最初接受了化疗和免疫疗法,但是随着疾病的复发,她接受大剂量治疗(HDT)和自体干细胞移植.
    Polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes (POEMS) syndrome is a rare multisystemic paraneoplastic disorder caused by an underlying plasma cell dyscrasia. Its diagnosis is based on the presence of two mandatory criteria and at least one major and one minor criterion. We report a case of a 52-year-old female patient who presented with complaints of acrocyanosis, night sweats, scaly skin, and swelling on the left side of the neck. She was a known case of hypothyroidism, antiphospholipid syndrome, and cerebral venous thrombosis, and had other comorbidities as well. She also exhibited weakness and paresthesia of the limbs and muscle wasting in the hands. All necessary examinations and investigations were performed and the patient was eventually diagnosed with POEMS syndrome. She underwent chemotherapy along with immunotherapy initially, but as the disease relapsed, she was referred for high-dose therapy (HDT) and autologous stem cell transplantation.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号