[基于利妥昔单抗的再生障碍性贫血伴单倍体同种异体移植后小儿伊普斯坦巴病毒相关淋巴细胞增生性疾病治疗:一项前瞻性单中心研究]。

F Zhang, G H Hu, P Suo, Z L Xu, L Bai, H F Wang, S Y M Huang, L P Xu, Y J Chang, X H Zhang, X J Huang, Y F Cheng
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引用次数: 0

摘要

与爱泼斯坦-巴氏病毒(EBV)相关的移植后淋巴组织增生性疾病(PTLD)是造血干细胞移植(HSCT)后最严重的并发症之一。本研究纳入了31例在单倍体移植后出现PTLD的再生障碍性贫血(AA)患者,总结了他们的临床特征,并根据单剂量利妥昔单抗治疗后病情是否改善1个对数值,将他们分为利妥昔单抗单药治疗组和联合治疗组。AA患儿造血干细胞移植后PTLD的发生率为10.16%,年龄大于10岁的患者PTLD发生率显著增加(χ(2)=11.336,P=0.010)。在 31 例患者中,27 例经临床诊断,4 例经病理确诊。最后,15 名患者被分为利妥昔单抗治疗组,15 名患者被分为联合治疗组。最后有 3 名患者死亡,2 年总生存率为(89.7±5.6)%。标准治疗前方案和EB病毒再激活是影响PTLD预后的危险因素。两种治疗方案对预后的影响在统计学上没有明显差异。
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[Rituximab based treatment in pediatric Epsstain Bar Virus associated lymphocyte proliferative diseases after aplastic anemia with haplo-identical transplantation:a prospective single centre study].

Epstein-Barr virus (EBV) associated post-transplant lymphoproliferative disorders (PTLD) are one of the most severe complications after hematopoietic stem cell transplantation (HSCT). This study includes 31 cases of aplastic anemia (AA) patients who developed PTLD after haploidentical transplantation, summarizing their clinical characteristics and categorizing them into either rituximab monotherapy group or combination therapy group based on whether their condition improved by 1 log after a single dose of rituximab. The incidence of PTLD after HSCT in children with AA was 10.16%, and the incidence of PTLD in patients with age >10 years was significantly increased (χ(2)=11.336, P=0.010). Of the 31 patients, 27 were clinically diagnosed and 4 were pathologically confirmed. Finally, 15 patients were classified into the rituximab treatment group and 15 patients into the combination treatment groups. Finally three patients died, and the 2-year overall survival rate was (89.7±5.6) %. Standard pre-treatment protocols and EBV reactivation are risk factors affecting the prognosis of PTLD. There was no statistically significant difference in the impact of the two treatment schemes on prognosis.

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