[脐带血移植治疗复发 T 淋巴细胞淋巴瘤后出现严重意识障碍]。

Naokazu Nakamura, Chisaki Mizumoto, Akihiko Sugimoto, Masakazu Fujimoto, Takashi Ayaki, Akifumi Takaori-Kondo
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引用次数: 0

摘要

T淋巴细胞白血病/淋巴瘤(T-ALL/LBL)预后不良。最近,奈拉滨对复发或难治性T-ALL/LBL患者的治疗效果相对较好,但需要仔细监测神经系统并发症。一名50岁的男子在异基因外周血干细胞移植后T-LBL早期复发,他接受了奈拉拉滨单药治疗,一个周期后病情完全缓解。随后,他接受了脐带血移植,并出现了持续的意识障碍。后来,他死于多器官衰竭,尸检结果表明,奈拉滨诱发的白质脑病导致了意识障碍。本病例提示医生应仔细监测患者是否出现神经系统并发症,并考虑进行影像学随访和向神经科医生咨询。
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[Severe consciousness disturbance after cord blood transplantation for relapsed T lymphoblastic lymphoma].

T-lymphoblastic leukemia/lymphoma (T-ALL/LBL) has a poor prognosis. Nelarabine has recently shown relatively good results in patients with relapsed or refractory T-ALL/LBL, but requires careful monitoring for neurological complications. A 50-year-old man with early recurrence of T-LBL after allogenic peripheral blood stem cell transplantation received nelarabine monotherapy and achieved complete remission after 1 cycle. He then received umbilical cord blood transplantation, and experienced sustained disturbance of consciousness. He later died of multiple organ failure, and autopsy suggested that nelarabine-induced leukoencephalopathy had caused the disturbance of consciousness. This case suggests that physicians should carefully monitor patients for neurological complications and consider imaging follow-up and consultation with a neurologist.

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