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HSCT 后复发性 EBV 相关 T/NK 细胞淋巴增殖性疾病中 DLI 诱导的缓解:一例病例报告

英文原题:DLI-induced remission in recurrent EBV-associated T/NK-cell lymphoproliferative disease following HSCT: a case report.

查看英文原题

DLI-induced remission in recurrent EBV-associated T/NK-cell lymphoproliferative disease following HSCT: a case report.

PubMed 2025/03/21(内容时间) Int J Hematol Q3 · IF 1.9(JCR 2025)

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研究概要

该病例凸显了 DLI 作为复发性 EBV 相关 T/NK-LPD 再移植替代治疗方案的潜力。

中文摘要

EB 病毒(EBV)相关 T/NK 细胞淋巴增殖性疾病(T/NK-LPD)的特征是感染 EBV 的 T 细胞或 NK 细胞发生克隆性增殖;进行性 T/NK-LPD 唯一可能治愈的治疗是异基因造血干细胞移植(HSCT)。关于 EBV 相关 T/NK-LPD 患者 HSCT 后疾病复发的最佳管理策略,相关报道有限。病例介绍:一名 2 岁女孩确诊为严重蚊虫叮咬过敏,这是 EBV 相关 T/NK-LPD 的皮肤型表现。接受人类白细胞抗原匹配的姐姐供者 HSCT 后,患者达到完全供者型嵌合,全血 EBV-DNA 载量转为无法检出。然而,随后全血 EBV-DNA 载量再次升高,供者型嵌合比例下降。为控制疾病复发,实施供者淋巴细胞输注(DLI)。接受 4 次 DLI 后,患者达到完全病毒学应答和完全供者型嵌合。整个治疗期间未观察到不良反应。

本病例提示,对于复发性 EBV 相关 T/NK-LPD,DLI 可能成为再次移植的替代治疗方式。

展开英文摘要原文

Epstein-Barr virus (EBV)-associated T/natural killer (NK)-cell lymphoproliferative diseases (T/NK-LPDs) are characterized by clonal proliferation of EBV-infected T or NK cells, and the only curative treatment for progressive T/NK-LPDs is allogeneic hematopoietic stem cell transplantation (HSCT). There are limited reports concerning optimal management strategies for disease relapse after HSCT in patients with EBV-associated T/NK-LPDs. CASE PRESENTATION: A 2-year-old girl was diagnosed with severe mosquito bite allergy, a cutaneous form of EBV-associated T/NK-LPD. Following HSCT from her human leukocyte antigen-matched sister, complete donor-type chimerism was achieved and whole blood EBV-DNA load became undetectable. However, the whole blood EBV-DNA load became elevated again and donor type chimerism decreased. Donor lymphocyte infusion (DLI) was performed to control the disease relapse. A complete virological response and complete donor-type chimerism were attained after four doses of DLI. No adverse effects were observed during the treatment course.

This case highlights the potential of DLI as an alternative therapeutic approach to re-transplantation for recurrent EBV-associated T/NK-LPDs.

论文信息

作者
Nagata T、Kubota H、Kato I、Izawa K、Akazawa R、Jo T、Arai Y、Azumi S
第一作者单位
Department of Pediatrics, Kyoto University Hospital, 54 Syogoin Kawaramachi Sakyo-Ku, Kyoto, 606-8507, Japan.Japan
通讯作者单位
Department of Pediatrics, Kyoto University Hospital, 54 Syogoin Kawaramachi Sakyo-Ku, Kyoto, 606-8507, Japan. itarkt@kuhp.kyoto-u.ac.jp.Japan
文献类型
病例报告
期刊
International journal of hematology2025 Jun
原文标识
PubMed 40117097 · DOI 10.1007/s12185-025-03965-7