不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Allogeneic HSCT For Pediatric Extranodal NK/T-Cell Lymphoma Transformed From Chronic Active Epstein-Barr Virus Infection: A Case Report.
Allogeneic HSCT For Pediatric Extranodal NK/T-Cell Lymphoma Transformed From Chronic Active Epstein-Barr Virus Infection: A Case Report.
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本研究旨在探讨慢性活动性EB病毒感染(CAEBV)转化型儿童结外NK/T细胞淋巴瘤(ENKTL)的临床特征、诊断标准、治疗方案及预后特点,为这类难治性疾病的规范化临床诊治提供循证参考。回顾性纳入深圳大学附属南山医院收治的1例CAEBV转化型ENKTL患儿,接受异基因造血干细胞移植(allo-HSCT)。患儿经多周期术前化疗后达到完全缓解。在预处理阶段及移植后期间全程给予含双歧杆菌、地衣芽孢杆菌和乳杆菌的三联益生菌制剂。移植后实现持续完全缓解,供者嵌合率为100%。移植后1年以上长期随访显示无疾病复发、EBV再激活、严重感染并发症及急慢性移植相关并发症。本病例研究证实,allo-HSCT治疗儿童CAEBV转化型ENKTL安全有效,其长期预后显著优于单纯化疗。围移植期辅助应用微生态制剂可能降低患儿呼吸道感染及移植物抗宿主病的风险。鉴于本研究为单病例研究且随访时间有限,结论在临床推广方面存在一定局限性。
This study aimed to explore the clinical characteristics, diagnostic criteria, therapeutic regimens, and prognostic features of pediatric extranodal natural killer/T-cell lymphoma (ENKTL) transformed from chronic active Epstein-Barr virus infection (CAEBV), to provide evidence-based references for standardized clinical diagnosis and treatment of these refractory diseases. A pediatric patient with CAEBV-transformed ENKTL admitted to Nanshan Hospital Affiliated to Shenzhen University was retrospectively enrolled in this study, who received allogeneic hematopoietic stem cell transplantation (allo-HSCT). The patient achieved complete remission after multiple cycles of preoperative chemotherapy. Triple probiotic preparations containing Bifidobacterium, Bacillus licheniformis, and Lactobacillus were administered throughout the preconditioning phase and post-transplant period.
Persistent complete remission was achieved after transplantation with full donor chimerism of 100%. Long-term follow-up over 1 year post-transplantation showed no disease recurrence, EBV reactivation, severe infectious complications, or acute and chronic transplantation-related complications. This case study confirmed that allo-HSCT is safe and effective for the treatment of pediatric CAEBV-transformed ENKTL, with a significantly superior long-term prognosis compared with chemotherapy alone.
Peri-transplant adjuvant application of microecological preparations may reduce the risks of respiratory tract infection and graft-versus-host disease in children. Given that this is a single-case study with limited follow-up duration, there are certain limitations in the clinical generalization of the conclusions.
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